Understanding Your Albumin-to-Creatinine Ratio Result
Your albumin-to-creatinine ratio has increased from 216 to 250 mg/g, which indicates moderately increased albuminuria (A2 stage) that is progressing and requires immediate medical intervention with blood pressure medications and close monitoring. 1
What This Test Measures
The albumin-to-creatinine ratio (Alb/Creat ratio) measures how much protein (albumin) is leaking into your urine compared to creatinine. 2
- Normal: Less than 30 mg/g 2, 1
- Moderately increased (A2): 30-299 mg/g 2, 1
- Severely increased (A3): 300 mg/g or higher 2, 1
Your result of 250 mg/g falls in the moderately increased range, meaning your kidneys are allowing more protein to leak through than they should. 1
What the Increase Means
The rise from 216 to 250 mg/g represents a 16% increase, which signals that your kidney function may be worsening. 1, 3 This is concerning because:
- Even values in the "moderately increased" range predict higher risk of heart attacks, strokes, and death 2, 4
- The increase suggests your current treatment may not be adequate 1
- Without treatment, 30-40% of people with your level progress to severely increased albuminuria (≥300 mg/g) within 5-10 years 2
However, one important caveat: albumin levels can vary significantly day-to-day (by as much as 4-fold), so this increase should be confirmed with at least one more test within 3-6 months before making major treatment changes. 2, 5
What You Need to Do Now
You must start or optimize treatment with an ACE inhibitor (like lisinopril) or ARB (like losartan) medication immediately. 1, 4 These medications are the cornerstone of treatment and have been proven to:
- Slow progression to kidney failure 2
- Reduce cardiovascular events and death 2, 4
- Lower albumin levels by ≥30%, which is the treatment goal 1, 3
Blood Pressure Control
Your blood pressure should be maintained below 140/90 mmHg (and ideally below 130/80 mmHg if you have diabetes). 2, 1, 6
If You Have Diabetes
Your blood sugar control (HbA1c) must be optimized to reduce further kidney damage. 2, 1
Monitoring Schedule
- Recheck your albumin-to-creatinine ratio in 3-6 months to confirm the trend 2, 1
- Check kidney function (serum creatinine and eGFR) at least annually 2
- Monitor potassium levels when starting ACE inhibitors or ARBs 2, 1
When to See a Kidney Specialist
You should be referred to a nephrologist if: 1, 4
- Your kidney function (eGFR) drops below 30 mL/min/1.73 m² 1
- Your albumin level reaches 300 mg/g or higher 4
- Your kidney function is rapidly declining 1
- There's uncertainty about what's causing your kidney problems 1
Important Warnings
Do not ignore this result. Your kidneys are signaling that your blood vessels throughout your body are damaged—this affects not just your kidneys but also your heart and brain. 2, 4, 6 The presence of albumin in your urine is actually a stronger predictor of heart attack and stroke than it is of kidney failure. 4
Factors that can temporarily raise your albumin levels include: exercise within 24 hours, fever, infection, uncontrolled high blood pressure, or very high blood sugar. 2 Make sure these weren't present when your test was done.