Urine albumin:creatinine ratio

Parsons M, Newman DJ, Pugia M, Newall RG, Price CP. Performance of a reagent strip device for quantitation of the urine albumin creatinine ratio in a point of care setting. Ciin Nephrol 1999 51 220-7. 

Semiquantitative methods of urine protein excretion, such as the spot urine albumin creatinine ratio, are recommended for determining the severity ofCKD and monitoring... 

Although not a quantitative measure of renal function, urinary microalbuminuria has been identified as an early marker of renal disease in patients with diabetic nephropathy and numerous other conditions, such as hypertension and obesity. Patients with microalbuminuria (30 to 300 mg/day) on at least two occasions or overt albuminuria (>300 mg/day) should begin to receive pharmacotherapy. For children, microalbuminuria is considered present if albumin excretion exceeds 0.36 mg/kg per day, and overt albuminuria has been defined as an excretion rate that exceeds 4 mg/kg per day. The urinary albumin creatinine ratio is also an accurate predictor of 24-hour proteinuria, a marker of renal disease. Guidelines for monitoring indicate that a urine albumin creatinine ratio of >30 mg/g places the patient at increased risk of developing diabetic nephropathy and is an indication for the initiation of pharmacotherapeutic intervention. Microalbuminuria has also been suggested as a risk factor for renal dysfunction among patients with essential hypertension. ... 

Claudi T, Cooper JG. Comparison of urinary albumin excretion rate in overnight urine and albumin creatinine ratio in spot urine in diabetic patients in general practice. Scand J Prim Health Care 2001 19 247-8. 

In the past, measurement of the urinary protein excretion rate was accomplished using a 24-hour urine collection in patients at risk for CKD. Use of an untimed "spot" urine sample with either an albumin-specific dipstick or measurement of albumin creatinine ratio is now recommended by some because it is more convenient than the extended-interval urine collection. 

Labs lytes, blood urea nitrogen (BUN)/creatinine, urine albumin, plasma aldosterone/plasma renin ratio to screen for excess aldosterone or mineralocorticoid production, or renin for renal artery stenosis (RAS) or renin-secreting tumor. 

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