If you’re looking up microalbumin creatinine ratio, you’re usually holding a lab result that says something like “uACR”, “albumin/creatinine ratio”, or “microalbuminuria.” And you’re asking the right question: Is this a kidney problem—or something temporary?
Here’s the key point: uACR is one of the best early signals of kidney damage, often showing changes before people feel symptoms. The CDC notes CKD is common—more than 1 in 7 American adults have CKD, and many don’t know it—so urine and blood tests like uACR and eGFR matter.
Educational only. Not medical advice or a diagnosis.
What is the microalbumin/creatinine ratio (uACR)?
The urine albumin-to-creatinine ratio (uACR) is a urine test that measures how much albumin (a protein) is leaking into your urine, adjusted for creatinine (a normal waste product). The CDC explains the uACR compares albumin to creatinine in your urine and helps estimate albumin passing into the urine over a 24-hour period.
NIDDK (NIH) describes albuminuria as a potential sign of CKD and states that uACR on a spot urine specimen is the recommended test to assess and monitor urine albumin.
Why the “ratio” matters
A urine dipstick can be affected by how concentrated your urine is. NIDDK’s uACR quick reference explains that uACR is a ratio between two measured substances and is unaffected by variation in urine concentration, unlike a dipstick.
Normal microalbumin creatinine ratio (uACR): what range is considered normal?
Most U.S. references use mg/g.
- Normal uACR: < 30 mg/g
- Above normal: ≥ 30 mg/g may indicate kidney disease (depending on context and repeat testing)
The National Kidney Foundation (NKF) states a normal amount of albumin in urine is less than 30 mg/g, and anything above 30 mg/g may mean kidney disease—even if your eGFR is above 60.
The CDC also notes that a urine albumin result of 30 or above may mean kidney disease, and that testing may be repeated to confirm.
Microalbuminuria vs. albuminuria (why terms vary)
You may see “microalbumin” on older labs. NKF explains that moderately increased albuminuria was historically called microalbuminuria and corresponds to ACR 30–300 mg/g.
Higher levels (often called “macroalbuminuria” historically) are generally ACR >300 mg/g.
In most modern kidney guidance, clinicians use:
- normal to mildly increased
- moderately increased
- severely increased
What does a high microalbumin creatinine ratio mean?
A high uACR means albumin is leaking into the urine, which can be an early sign of kidney damage. NKF notes albumin in urine can be a sign of kidney disease even when eGFR is “normal,” and that many people don’t feel symptoms.
Key interpretation (simple and clinically aligned)
- uACR < 30 mg/g: usually normal
- uACR 30–300 mg/g: moderately increased albuminuria (historically “microalbuminuria”)
- uACR > 300 mg/g: severely increased albuminuria (higher risk category)
One important nuance
A high uACR does not automatically mean permanent CKD. That’s why clinicians confirm it and look for temporary causes.
Can uACR be falsely high? Yes—this is why repeat testing matters
The CDC specifically notes the urine albumin test may be repeated once or twice to confirm results.
NKF also notes your healthcare team may re-check to ensure albuminuria isn’t caused by something else.
Common reasons uACR can be temporarily elevated include acute illness or factors around collection. (Your clinician will interpret your result in context and may request repeat testing.)
Who should get a uACR test?
uACR is especially valuable for people at higher risk for CKD.
NIDDK’s kidney disease statistics note that CKD affects more than 1 in 7 U.S. adults (estimated 35.5 million Americans) and that risk is higher in people with diabetes or high blood pressure.
If you have:
- diabetes
- hypertension
- heart disease
- a family history of kidney disease
- or you’ve been told your eGFR is declining
…uACR is one of the most useful tests to clarify risk and guide care.
What should you do if your microalbumin creatinine ratio is high?
This depends on the number and your overall health, but here is the clinically practical pathway:
Confirm it (don’t panic on a single test)
Because uACR can fluctuate, clinicians often repeat it. CDC highlights that repeat testing may be done to confirm.
Pair it with eGFR (the two numbers belong together)
NKF’s CKD classification approach uses both GFR category (eGFR) and albuminuria category (uACR)—often referred to as CGA staging (Cause, GFR, Albuminuria).
Treat the drivers (this is how you protect kidneys long-term)
If albuminuria is persistent, clinicians focus on:
- blood pressure control
- diabetes control
- kidney-protective medications when appropriate
- lifestyle/nutrition changes tailored to labs
(Your primary care doctor or nephrologist guides this; the goal is lowering kidney stress and reducing future risk.)
NKF’s management guidance also uses uACR thresholds in referral decision-making (e.g., very high uACR can warrant nephrology involvement).
Frequently Asked Questions
What is a normal microalbumin creatinine ratio?
Generally < 30 mg/g is considered normal.
What does uACR 30 mg/g mean?
A value 30 mg/g or higher may indicate kidney disease and is often rechecked to confirm.
Can uACR be high even if eGFR is normal?
Yes. NKF notes that anything above 30 mg/g may mean kidney disease even if eGFR is above 60.
Is uACR better than a urine dipstick?
For albumin assessment, yes in many cases. NIDDK notes uACR is unaffected by urine concentration variability, unlike a dipstick test.
Does a high uACR mean I will need dialysis?
Not automatically. uACR is a risk marker and helps guide monitoring and treatment. Many people stabilize when underlying drivers are controlled and results are followed over time.
Most uACR concerns are handled with outpatient follow-up, repeat testing, and prevention-focused care. But if you’re in Houston and you feel significantly unwell—especially with symptoms that suggest dehydration, severe infection, or rapidly worsening swelling/breathing issues—getting evaluated sooner is reasonable.
Post Oak ER states it is open 24/7 and provides on-site laboratory services and advanced on-site diagnostics, including imaging such as CT, X-ray, and ultrasound.
They also note they are open 24/7 near The Galleria.