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Interpret Your Albumin-to-Creatinine Ratio (Spot) Results

Enter your ACR value below and get an instant, free AI interpretation — a plain-English explanation checked against WHO/IFCC reference ranges.

Medical Disclaimer

This AI-generated interpretation is for educational purposes only and does not constitute medical advice, diagnosis, or treatment. Results may vary based on individual health factors not captured here.

Always consult a qualified healthcare professional before making any health decisions. Read full disclaimer →

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Albumin-to-Creatinine Ratio (Spot) Normal Ranges

The Albumin-to-Creatinine Ratio (ACR), measured on a spot (random) urine sample, is the preferred test for detecting and quantifying urine albumin excretion in clinical practice.

Reference RangeUnitNotes
0 – 30mg/gNormal (A1 category)
30 – 300mg/gModerately increased (A2) — formerly microalbuminuria
300 – 9999mg/gSeverely increased (A3) — formerly macroalbuminuria

Also reported in: mg/mmol.

Why Doctors Order the Albumin-to-Creatinine Ratio (Spot) Test

ACR is the most important test for detecting early kidney disease in diabetes and hypertension. Microalbuminuria (ACR 30–300 mg/g, formerly called "microalbuminuria") is the earliest detectable sign of diabetic nephropathy and indicates glomerular endothelial damage.

How to Enter Your ACR Result

Albumin-to-Creatinine Ratio (Spot) can be reported in mg/g or mg/mmol. Choose the unit printed next to your result on the lab report so it is compared with the matching reference range.

What a Low or High ACR Can Be Associated With

Below the reference range

  • ACR <30 mg/g is normal — represents healthy glomerular filtration barrier function

Above the reference range

  • Diabetic nephropathy (most common cause of elevated ACR)
  • Hypertensive kidney disease
  • Glomerulonephritis (any cause)
  • Lupus nephritis
  • Pre-eclampsia in pregnancy

These are common associations, not a diagnosis. A single result is read alongside your symptoms, history and other tests — discuss it with your doctor.

What Can Change Your ACR Result

Before you read too much into a result, consider whether any of these applied:

  • Vigorous exercise within 24 hours falsely raises ACR — always test on rest day
  • UTI and fever transiently raise ACR — retest after resolution
  • Highly concentrated or dilute urine samples affect ratio accuracy (extreme hydration or dehydration)
  • Orthostatic proteinuria (benign, mainly in young adults) — collect first morning specimen lying flat to avoid

Preparing for the test: A first morning midstream urine sample is preferred (minimizes the effect of orthostatic proteinuria and exercise). Collect on a day without vigorous exercise.

Symptoms That Often Prompt ACR Testing

  • Microalbuminuria (ACR 30–300): typically asymptomatic
  • Macroalbuminuria (ACR >300): may develop foamy urine, ankle edema, hypertension
  • Nephrotic-range proteinuria (ACR >3000): edema, hypoalbuminemia, hyperlipidemia, increased thrombosis risk

Want the full clinical guide to Albumin-to-Creatinine Ratio (Spot)?

Reference ranges, causes, symptoms, preparation, and FAQs.

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