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Albumin-Creatinine Ratio: About This Test

Kidneys, ureters, bladder

What is it?

An albumin-creatinine ratio test compares the amounts of albumin and creatinine in your urine.

Albumin (say "al-BYOO-mun") is normally found in the blood. When the kidneys are damaged, small amounts of albumin (microalbumin) leak into the urine.

Creatinine (say "kree-AT-uh-neen") is a waste product found in urine.

Why is this test done?

This test helps your doctor see how well your kidneys are working. It is done most often to check the kidneys in people with diabetes. It may also be done to check people with high blood pressure, heart failure, and cirrhosis.

How can you prepare for the test?

  • Do not exercise just before the test.
  • Tell your doctor if you are having your period or have vaginal discharge.
  • Tell your doctors ALL the medicines and natural health products you take. Some of these can affect the results of this test.

What happens before the test?

  • Your doctor or the lab will probably give you the container you need to hold the urine and give you instructions on when and how to collect the urine. This might be a one-time collection or a collection over a period of time.

What happens during the test?

One-time urine collection

  • Wash your hands.
  • If the collection cup has a lid, remove it carefully and set it down with the inner surface up. Don't touch the inside of the cup.
  • Clean the area around your genitals.
    • For men: Retract the foreskin, if present, and clean the head of your penis with medicated towelettes or swabs.
    • For women: Spread open the genital folds of skin with one hand. Then use your other hand to clean the area around the urethra with medicated towelettes or swabs. Wipe the area from front to back so bacteria from the anus are not wiped across the urethra.
  • Begin urinating into the toilet or urinal. If you are a woman, hold apart the genital folds of skin while you urinate.
  • After the urine has flowed for several seconds, place the collection cup into the urine stream and collect about 60 millilitres of this "midstream" urine without stopping your flow of urine.
  • Don't touch the rim of the cup to your genital area. Don't get toilet paper, pubic hair, stool (feces), menstrual blood, or anything else in the urine sample.
  • Finish urinating into the toilet or urinal.
  • Carefully replace and tighten the lid on the cup, and then return it to the lab. If you are collecting the urine at home and can't get it to the lab in an hour, refrigerate it.

Urine collection over time

You collect your urine for a period of time, such as over 4 or 24 hours.

  • Start collecting your urine in the morning. When you first get up, empty your bladder, but don't save this urine. Write down the time that you urinated to mark the beginning of your collection period.
  • For the set period of time, collect all your urine. Urinate into a small, clean container as noted in the instructions above, and then pour the urine into the large container. Don't touch the inside of this container with your fingers. Keep the large container in the refrigerator.
  • Empty your bladder for the final time at or just before the end of the collection period. Add this urine to the large container, and write down the time.

What else should you know about the test?

  • Your results will include an explanation of what a "normal" result is. This is called a "reference range." It is just a guide. Your doctor will evaluate your results based on your health and other factors. This means that a value that falls outside the normal values listed may still be normal for you.
  • If your results are higher than normal, your doctor may check your urine more often to watch for kidney damage.
  • If your test shows that you may have kidney damage, other tests may be done.

What happens after the test?

  • Follow your doctor's instructions for taking the urine to the doctor's office or lab.
  • You can go back to your usual activities right away.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to keep a list of the medicines you take. Ask your doctor when you can expect to have your test results.

Where can you learn more?

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Care instructions adapted under license by your healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.