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Urine albumin-to-creatinine ratio An early sign of kidney damage

Also called UACR, ACR and Microalbumin/creatinine ratio Not on a standard checkup No fasting needed

The short answer

This urine test measures albumin, a protein that healthy kidneys keep in your blood. Under 30 mg/g is normal. A higher result, confirmed on repeat tests, is a sign of kidney damage, and it can show up while your eGFR is still normal.1,2

A good result
Under 30 mg/g.1,2
If yours is high
Repeat it. Exercise, a fever or an infection can raise it for a while. If 2 of 3 tests over 3 to 6 months are 30 or more, it’s a sign of kidney damage, and treatment can bring it down.2,3
Should you test?
Yes, every year if you have high blood pressure, diabetes or heart disease. US guidelines now recommend it for everyone with high blood pressure.3,4,5

Check your result

Type the number from your report. It stays on this page.

30 300
  • Normal Under 30
  • Moderately increased 30 to 299
  • Severely increased 300 or more

Enter your result to see what it means and what to do next.

Got a result from another lab? Ask Picardo about it. The app explains your results, and a physician can follow up.

Categories from the KDIGO 2024 guideline. Labcorp uses the same cutoffs.1,2 One raised result needs repeating before it counts. The bar isn’t to scale.

What is a normal urine albumin-to-creatinine ratio?

Labs report the ratio in mg of albumin per g of creatinine. Under 30 is normal. A higher result only counts as kidney damage if 2 of 3 tests over 3 to 6 months are raised:1,2

Normal Under 30 mg/g

Normal

Your kidneys are keeping albumin in your blood, where it belongs.1

How worried to be

Nothing to worry about.

What to do next
  1. 1 If you have high blood pressure, diabetes or heart disease, recheck every year.3,4,5
  2. 2 Check your eGFR too. The two tests catch different problems.1
Moderately increased 30 to 299 mg/g

Moderately increased: confirm it

If 2 of 3 tests over 3 to 6 months are in this range, it counts as chronic kidney disease, even with a normal eGFR.1,2 In a study of millions of adults with a normal eGFR, people in this range had about 1.8 times the risk of death from any cause, 2 times the risk of heart failure and 4 times the risk of kidney failure, compared with people under 10.6

How worried to be

Not urgent, but worth acting on over the next few months.

What to do next
  1. 1 Repeat it on a first-morning sample. Exercise in the past day, a fever, an infection or a period can raise it for a while.1,2
  2. 2 If 2 of 3 tests over 3 to 6 months are 30 or more, see a clinician about blood pressure, medicines that protect your kidneys and, if you’re 50 or older, a statin.1,2,3
  3. 3 Check your eGFR and blood sugar.1,3
Severely increased 300 mg/g or more

Severely increased

This much albumin is a strong sign of kidney damage, once a repeat test confirms it.1 In a study of millions of adults with a normal eGFR, a result of 300 to 999 went with about 2.6 times the risk of death from any cause and 12 times the risk of kidney failure, compared with under 10.6

How worried to be

See a clinician in the next few weeks.

What to do next
  1. 1 Confirm it with a repeat test, and check your eGFR.1
  2. 2 Ask about an ACE inhibitor or ARB and an SGLT2 inhibitor. Guidelines recommend both at this level, with or without diabetes.1,5
  3. 3 KDIGO advises seeing a kidney specialist if it stays over 700 or doubles on a later test, or if there’s also blood in your urine.1
Heart Health panel
$150.90 · Urine albumin-to-creatinine ratio plus 16 more tests, one visit
Order
Or order just the urine albumin test, $10.50

What is the urine albumin-to-creatinine ratio?

Think of your kidneys as a sieve. Albumin is too big to get through a healthy one. When the sieve gets damaged, albumin starts leaking into your urine.

Albumin is the main protein in your blood. Healthy kidneys keep almost all of it in. The test measures how much reaches your urine and divides it by creatinine, so a single sample works, though a first-morning one is best.1

It’s one of the two tests guidelines use to find kidney disease. eGFR shows how well your kidneys filter; this one shows whether they’re leaking. Either can be abnormal while the other is normal, which is why you need both.1

Why does albumin in your urine matter?

Albumin in your urine goes with a higher risk of heart disease, not just kidney disease. In a study of millions of adults, even a result of 30 to 299 with a normal eGFR went with higher risks of heart attack, stroke, heart failure and death.6

That’s why US heart and diabetes guidelines now ask for this test, and why the PREVENT calculator clinicians use for heart risk can take it into account.3,4,5

How to lower urine albumin

  • ACE inhibitors or ARBs

    The usual first step. KDIGO and the ADA recommend them when urine albumin is raised, most strongly at 300 mg/g or more.1,3

    How much it helps
    Some
    How sure we are
    Very sure
  • SGLT2 inhibitors

    Recommended from an eGFR of 20 with type 2 diabetes, and at 200 mg/g or more without it. Their main job is slowing kidney decline rather than lowering albumin.1,5

    How much it helps
    A little
    How sure we are
    Very sure
  • Finerenone, with type 2 diabetes

    Added to an ACE inhibitor or ARB.1,3 Started together with an SGLT2 inhibitor, it lowered urine albumin about 30% more than either drug alone over 6 months.7

    How much it helps
    Some
    How sure we are
    Very sure
  • Lower blood pressure and less salt

    KDIGO suggests a top number under 120 if you can tolerate it, and under 2 g of sodium a day.1

    How much it helps
    Some
    How sure we are
    Fairly sure
  • Better blood sugar

    With diabetes, the ADA advises good glucose control to slow kidney disease.3

    How much it helps
    A little
    How sure we are
    Fairly sure

Treatment is widening. In 2026, finerenone slowed kidney decline in 1,584 people with kidney disease, no diabetes and urine albumin of 200 to 3,500 mg/g, all already on an ACE inhibitor or ARB. The difference was about 0.7 points of eGFR a year compared with a placebo.8 The FDA also approved it for kidney disease with type 1 diabetes, based on how much it lowered urine albumin.9

Who should get a urine albumin test?

US guidelines recommend it every year, alongside eGFR, if you have:3,4,5

  • High blood pressure. Since 2025, US guidelines recommend it for everyone diagnosed with high blood pressure.4,5
  • Type 2 diabetes, or type 1 diabetes for 5 years or more.3
  • High triglycerides, metabolic syndrome or heart disease.5
  • Kidney disease, and more often if your risk is high.1

A first-morning sample gives the most reliable result. Whatever the time, skip hard exercise for 24 hours before.1,2

How to get a urine albumin-to-creatinine ratio test, and what it costs

It comes from the urine albumin test, which costs $10.50 through Picardo. The Heart Health panel adds 16 more tests from the same visit for $150.90.

Recommended

Heart Health panel

$150.90
17 tests · fast for 12 hours first

Urine albumin is half of a kidney check. The panel adds eGFR from a metabolic panel, heart tests such as ApoB and Lp(a), and HbA1c for blood sugar. See what’s in it

Order the Heart Health panel
Just this test

Urine albumin test

$10.50
Labcorp 140285 · no fasting needed

The test this number comes from.

Order the urine albumin test
  • Results in 2 to 3 days, in the app
  • Physician follow-up if you want one
  • Free Labcorp draw, or $75 at home
  • No other fees. HSA and FSA eligible.

It’s also part of the Base Core Annual – Men and Base Core Annual – Women panels, if you want a wider checkup.

Already have a result? Ask Picardo about it

Questions people ask

Is protein in the urine the same as albumin?

Not quite. Albumin is the main protein that leaks from damaged kidneys, and KDIGO prefers testing for it. A urine protein test counts other proteins too, and dipsticks are less precise than a lab ratio.1

Is a UACR of 20 normal?

Yes, it’s under the 30 mg/g cutoff. In large studies, risk starts to rise gradually from about 10, but guidelines don’t count it as raised until 30.1,6

Can urine albumin go back down?

Yes. Kidney-protecting medicines lower it, and when it’s 300 or more, the ADA advises aiming to cut it by at least 30%.3 In September 2026 the FDA approved finerenone to lower urine albumin in adults with kidney disease and type 1 diabetes, because that’s expected to cut the risk of kidney failure.9

Why does the test compare albumin with creatinine?

Your urine gets more or less concentrated through the day. Dividing albumin by creatinine, which you pass at a fairly steady rate, corrects for that, so one sample works.1

Is the normal range different for women?

No. US labs and guidelines use 30 mg/g for everyone.1,2 Women and people with less muscle pass less creatinine, though, so the same amount of albumin gives them a slightly higher ratio.1

Often checked alongside

eGFR
How well your kidneys filter
Creatinine
Muscle waste the kidneys filter out
HbA1c
Average blood sugar over three months
Cystatin C
Kidney filtration marker less affected by muscle mass than creatinine

Test details

Labcorp test
Albumin/Creatinine Ratio, Random Urine, 140285
LOINC
9318-7
Sample
Urine. A first-morning sample is best.1
Fasting
Not needed. Skip hard exercise for 24 hours first.2
Typical lab range
0 to 29 mg/g creatinine2
Units
mg of albumin per g of creatinine in the US. 30 mg/g is about 3 mg/mmol.1

Sources

  1. 1 Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int. 2024;105(4S):S117–S314. doi.org/10.1016/j.kint.2023.10.018
  2. 2 Labcorp. Albumin/creatinine ratio, random urine, test 140285. Labcorp test menu. Accessed October 28, 2026. www.labcorp.com/tests/140285/albumin-creatinine-ratio-random-urine
  3. 3 American Diabetes Association Professional Practice Committee for Diabetes. 11. Chronic kidney disease and risk management: Standards of Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1):S246–S260. doi.org/10.2337/dc26-S011
  4. 4 Jones DW, Ferdinand KC, Taler SJ, et al. 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM guideline for the prevention, detection, evaluation and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2025;152(11):e114–e218. doi.org/10.1161/CIR.0000000000001356
  5. 5 Ndumele CE, Rodriguez F, Dixon DL, et al. 2026 AHA/ACC/ADA/ASN guideline for the prevention, detection, evaluation, and management of cardiovascular-kidney-metabolic syndrome: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2026;154(4):e50–e158. doi.org/10.1161/CIR.0000000000001453
  6. 6 Writing Group for the CKD Prognosis Consortium; Grams ME, Coresh J, Matsushita K, et al. Estimated glomerular filtration rate, albuminuria, and adverse outcomes: an individual-participant data meta-analysis. JAMA. 2023;330(13):1266–1277. doi.org/10.1001/jama.2023.17002
  7. 7 Agarwal R, Green JB, Heerspink HJL, et al. Finerenone with empagliflozin in chronic kidney disease and type 2 diabetes. N Engl J Med. 2025;393(6):533–543. doi.org/10.1056/NEJMoa2410659
  8. 8 Heerspink HJL, Neuen BL, Agarwal R, et al. Finerenone in persons with chronic kidney disease without diabetes. N Engl J Med. 2026;395(6):533–545. doi.org/10.1056/NEJMoa2604625
  9. 9 US Food and Drug Administration. Supplement approval letter: Kerendia (finerenone) tablets, NDA 215341/S-011. September 16, 2026. www.accessdata.fda.gov/drugsatfda_docs/appletter/2026/215341Orig1s011ltr.pdf

Updated 28 Oct 2026.

This is general health information, not medical advice: talk to your clinician about your results and before changing any treatment.