ACR stands for albumin-to-creatinine ratio. It is a urine test that checks how much albumin, a type of protein, is leaking into your urine. A higher ACR usually means the kidney filters are under stress or damaged.
Healthy kidneys usually keep protein in your bloodstream. When the kidney filters are injured, albumin can leak through into the urine.
That makes ACR one of the most useful early warning signs in kidney disease. A high ACR can show up before your eGFR falls very much, which is why doctors pay close attention to it.
The result is often reported in milligrams of albumin per gram of creatinine: mg/g.
This is usually the target range. Your clinician may still watch it over time if you have kidney risk factors.
This can be an early sign of kidney damage, even when creatinine or eGFR do not look very abnormal yet.
This means a larger amount of protein is leaking through the kidney filters and it needs close attention.
Because ACR can move around, your doctor may repeat the urine test before making big treatment decisions, especially if you were sick or dehydrated.
For many kidney patients, blood pressure control is one of the fastest ways to reduce albumin leak and slow kidney damage.
Medicines like lisinopril or losartan are commonly used because they lower pressure inside the kidney filters and often reduce urine albumin.
If you have diabetes, keeping glucose in range can reduce stress on the kidney filters and lower albumin over time.
Lower sodium intake can help blood pressure medicines work better and can reduce swelling and pressure on the kidneys.
Some patients may benefit from additional kidney-protective treatments depending on their diagnosis and diabetes status.
A single high ACR matters, but the trend over time matters more. Your doctor may repeat the test to confirm it was not temporary.
ACR becomes much more useful when you can compare it with your blood pressure, meds, and other kidney labs over time.
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