Urine albumin-to-creatinine ratio (UACR)

The urine albumin-to-creatinine ratio (UACR) measures how much albumin is leaking into your urine, divided by your urinary creatinine (which corrects for how hydrated you are). A healthy kidney filter keeps almost all albumin in your blood. So a persistent UACR of 30 mg/g or higher signals a breach in that filter (the glomerular membrane or endothelium). Values of 300 mg/g or more mean overt 'macroalbuminuria'. Together with estimated GFR (eGFR), UACR is one of the two pillars of the KDIGO 2024 system for staging chronic kidney disease and gauging risk. But it tells you more than kidney health. Albumin escaping your kidney capillaries mirrors leakiness in blood vessels all over your body. So UACR predicts heart events, independent of the usual risk factors. In the PREVEND cohort (Hillege et al. 2002, about 40,500 general-population adults), even sub-clinical albuminuria below 30 mg/g showed a continuous, graded link to all-cause and cardiovascular death, independent of blood pressure, diabetes, and kidney function. And a 2023 KNHANES study (Kim et al., 19,340 Korean adults) confirmed that a UACR above 30 mg/g goes with higher heart risk, in both diabetics and non-diabetics. Screening needs only a single morning or random urine sample. But two or more high readings, at least three months apart, are needed to tell persistent from temporary albuminuria.

Last reviewed: June 22, 2026

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