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Single Biomarker

Albumin / Creatinine Ratio, 24 Hrs Urine

24-Hr Albumin/Creatinine Ratio

This test measures the ratio of albumin to creatinine in a 24-hour urine collection. It is used to detect early kidney damage, particularly in diabetes and hypertension patients.

24-HOUR URINE24 HOURSNO FASTING
AEDAED129
  • Free home collection
  • Physician-reviewed report

24 Hours

Turnaround

24-Hour Urine

Sample

About This Test

What the Albumin / Creatinine Ratio, 24 Hrs Urine test tells you

Healthy kidneys hold albumin back. It is the most abundant protein in blood, and the filtering units are built to let waste through while keeping proteins of that size in circulation. When those filters are damaged, albumin begins to escape into the urine, and it does so long before any change shows up in blood tests of kidney function. Measuring urinary albumin is therefore one of the earliest practical windows onto kidney injury, and, importantly, it opens at a stage when treatment can still slow or reverse the process.

The complication is that urine concentration swings through the day with how much you drink, so the raw amount of albumin in a sample is a poor guide on its own. Creatinine is excreted at a fairly steady rate, so expressing albumin against creatinine cancels out the dilution effect and produces a figure that stands comparison between samples and between people. This version of the test applies that calculation to a full twenty-four hour collection, which additionally averages out shorter fluctuations caused by posture, activity and time of day.

The timed collection is more demanding than handing in a single sample, which is why routine screening usually uses a spot ratio instead. This version earns its place when precision matters most: confirming an abnormal spot result, quantifying protein loss for a kidney clinic, following someone whose treatment is being adjusted, or assessing protein in pregnancy. Whichever method is used, one abnormal result is rarely acted on alone. Albumin leak rises transiently after vigorous exercise, during a fever or urinary infection, in heart failure and around menstruation, so the test is normally repeated before anything is concluded: persistence, not a single value, is what points to something structural.

Sample type
24-Hour Urine
Measured in
mg/g
Turnaround
24 Hours
Fasting
Not required
Best for
All ages
Why Get Tested?

Recommended for patients with diabetes, hypertension, or a family history of kidney disease to screen for early kidney damage and guide preventive treatment.

  • Detecting early kidney damage

    Albumin appears in urine well before blood measures of kidney function change, giving the earliest practical warning in diabetes and high blood pressure.

  • Confirming an abnormal screen

    A timed collection removes much of the hour-to-hour variation that can make a single random sample misleading.

  • Guiding protective treatment

    The result influences whether medicines that reduce protein leak and protect the kidney are started or increased.

  • Following known kidney disease

    Repeated measurements show whether albumin loss is stable, improving on treatment, or progressing.

When This Test Is Ordered

Reasons your doctor may request the Albumin / Creatinine Ratio, 24 Hrs Urine test

Your doctor may order this test for any of the reasons below. Some are routine checks, others follow specific symptoms or an earlier result.

  • Diabetes & blood pressure

    • You have diabetes and an earlier random urine result needs confirming properly.
    • You have high blood pressure and your doctor is checking for kidney involvement.
    • A family history of kidney disease means your doctor wants a careful baseline.

  • Precise quantification

    • You attend a kidney clinic and precise quantification of protein loss is needed.
    • You are pregnant and protein in the urine needs quantifying accurately.

  • Treatment response

    • Treatment to reduce protein leak has been started and its effect is being measured.
Preparation
The short version
No prep needed.
  • 24-Hour Urine
  • Free home collection
  • No fasting
  • Results in 24 Hours
  1. 1
    Book any time

    No fasting window: pick any slot that suits you, online or on WhatsApp.

  2. 2
    We come to you

    A DHA-licensed nurse collects your sample at home or in the office: free home collection.

  3. 3
    Results in 24 Hours

    A physician-reviewed, easy-to-read report lands securely by WhatsApp and email.

Prep note
Physician reviewed

No fasting is required.

The accuracy of this test rests almost entirely on the collection, so follow the instructions closely: empty your bladder and discard that urine at the start time, then collect every subsequent passing of urine, including one at exactly the same time the following day, into the container provided. Keep the container closed and cool between additions.

Avoid strenuous exercise during the collection, and postpone the test if you have a urinary infection, a fever, or are menstruating, since all of these raise albumin in urine without kidney disease. Drink as you normally would rather than loading up on fluids.

Tell your doctor about blood pressure medicines, anti-inflammatory painkillers and any recent scan using contrast dye.

Understanding Your Results

A result in the Normal band, reported in mg/g, means little albumin is reaching the urine and is the healthy finding. The Microalbuminuria band signals a small but real leak: the earliest routinely detectable sign of kidney involvement in diabetes and high blood pressure, and the stage at which treatment can often slow or reverse the process. A result in the High band indicates significant albuminuria and should be discussed with your doctor promptly. One abnormal value settles little. Albumin excretion rises temporarily after vigorous exercise, during a fever or urinary infection, in heart failure and around menstruation, and an incomplete or badly timed collection can shift the figure either way, so the test is normally repeated before anything is concluded. Your doctor reads it with your kidney blood tests, your blood pressure and your history.

SmartReport
30300
Healthy zone15mg/gNormal
Reference ranges · mg/g
Normal
Normal: no significant albumin in urine.
0–29
Microalbuminuria
Early kidney involvement: discuss with your physician.
30–299
High
Significant albuminuria: consult your physician.
300–3000

Ranges are a guide: your physician interprets your result alongside your symptoms and history.

Reading a High or Low Result

  • What a higher result can point to

    • Diabetic kidney disease, in which albumin leak is often the first detectable sign.
    • Kidney damage from long-standing high blood pressure.
    • Glomerular disease, where the filtering membranes themselves are inflamed or scarred.
    • A urinary tract infection, a fever, or blood contaminating the sample.
    • Vigorous exercise shortly before or during the collection, and heart failure, both of which raise albumin excretion temporarily.
    • Pre-eclampsia and other pregnancy-related kidney stress.

These are possibilities, not diagnoses. A single value outside the reference range is interpreted alongside your symptoms, history and other tests: your doctor decides what it means for you.

Limitations & Safety

What this test cannot tell you

  • A single raised result does not establish kidney disease; the finding must persist across separate samples taken on different days, because transient rises are common.
  • An incomplete or badly timed collection is the commonest source of error and can shift the result in either direction.
  • Infection, fever, menstrual blood and recent strenuous exercise raise albumin excretion without any kidney disease being present.
  • The test measures albumin specifically and will miss other urinary proteins, which need a different test.

Risks of the blood draw

  • Mild bruising or brief soreness where the needle went in.
  • Occasional lightheadedness, which settles after a few minutes of rest.
  • Bleeding or infection at the site, which is rare with sterile single-use equipment.
Key Points
  • 1Albumin in urine is one of the earliest signs of kidney damage, appearing before blood tests change.
  • 2Expressing albumin against creatinine corrects for how dilute or concentrated the urine happens to be.
  • 3A low ratio is the normal, healthy finding and needs no action.
  • 4Collection technique matters as much as the laboratory work: missing urine invalidates the result.
  • 5Because a rise can be transient, an abnormal result is repeated before your doctor acts on it.
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Because urine can be dilute or concentrated depending on what you have drunk, and that alone can move the albumin figure substantially. Creatinine is excreted at a steady rate, so using it as the yardstick removes that distortion and makes samples genuinely comparable.