What is the interpretation of my normal albumin-to-creatinine ratio in a random urine test?

Interpretation of Your Normal Albumin-to-Creatinine Ratio

Your albumin-to-creatinine ratio of 25 mg/g creatinine is within the normal range (A1 category: <30 mg/g) and indicates no evidence of kidney damage at this time. 1

Understanding Your Results

Your test shows:

• Urine albumin: 0.3 mg/dL
• Urine creatinine: 12 mg/dL
• Albumin/creatinine ratio: 25 mg/g creatinine

This ratio falls into the A1 category (Normal to Mildly Increased Albuminuria), defined as <30 mg/g creatinine. 1 This classification indicates your kidneys are filtering albumin at a normal rate and there is no current evidence of diabetic kidney disease or other kidney damage. 1

Clinical Significance

While your result is normal, it's important to understand that:

• The albumin-to-creatinine ratio is a continuous marker for cardiovascular and kidney disease risk, meaning risk exists on a continuum even within the normal range. 1

• Recent research suggests that values consistently above 10 mg/g may carry increased risk for chronic kidney disease progression in patients with type 2 diabetes, even though they remain below the 30 mg/g threshold. 2

• Your value of 25 mg/g, while normal, is in the higher end of the normal range and warrants continued monitoring, particularly if you have diabetes, hypertension, or other cardiovascular risk factors. 1

Recommended Follow-Up

If you have diabetes:

• Continue annual screening with albumin-to-creatinine ratio testing using first morning urine samples to minimize variability. 1, 3
• Monitor both your albumin-to-creatinine ratio and estimated glomerular filtration rate (eGFR) at least annually. 1

If you do not have diabetes but have other risk factors (hypertension, cardiovascular disease, family history of kidney disease):

• Periodic monitoring is reasonable, though specific intervals should be determined based on your overall risk profile. 1

Important Caveats

Factors that can temporarily elevate your ratio (leading to false-positive results) include: 3

• Exercise within 24 hours before testing
• Fever or active infection
• Marked hyperglycemia
• Menstruation
• Uncontrolled hypertension
• Congestive heart failure

Due to high biological variability (>20% between measurements), any future abnormal result (≥30 mg/g) should be confirmed with 2 additional tests over a 3-6 month period before diagnosing albuminuria. 1, 3

Optimal Testing Practices

For future testing, request:

• First morning void urine sample (lowest coefficient of variation at 31%). 3
• Testing at the same time of day with no food intake for 2 hours prior to collection to minimize variability. 3