Urine Albumin-to-Creatinine Ratio
UrinanalyseZuletzt geprüft: 7. April 2026. Quellenansatz: Standardkontext zur Laborinterpretation, allgemeine medizinische Referenzmaterialien sowie öffentliche Gesundheits- oder klinische Leitlinien, sofern relevant.
Was ist Urine Albumin-to-Creatinine Ratio?
The urine albumin-to-creatinine ratio (UACR) is a convenient and standardized method for quantifying urinary albumin excretion from a spot (random) urine sample, eliminating the need for a timed 24-hour urine collection. Albumin is a large protein that is normally retained by the glomerular filtration barrier. When the kidneys are damaged, this barrier becomes more permeable, allowing albumin to leak into the urine—a condition known as albuminuria. By dividing the urine albumin concentration by the urine creatinine concentration, the UACR corrects for variations in urine dilution, providing a reliable estimate of daily albumin excretion.
UACR is the recommended test for detecting and monitoring albuminuria, which is a hallmark of diabetic kidney disease and a key marker in the staging of chronic kidney disease (CKD). Current KDIGO guidelines classify albuminuria into three categories: normal to mildly increased (<30 mg/g), moderately increased (30–300 mg/g, formerly called "microalbuminuria"), and severely increased (>300 mg/g, formerly called "macroalbuminuria"). UACR is also an independent cardiovascular risk factor—elevated albuminuria predicts heart attack, stroke, and heart failure even in the absence of overt kidney disease.
Warum der Wert wichtig ist
UACR is one of the earliest detectable markers of kidney damage, often appearing years before eGFR begins to decline. In diabetes, persistent moderately increased albuminuria is the first clinical sign of diabetic nephropathy and identifies patients who benefit most from intensified treatment with RAAS inhibitors (ACE inhibitors or ARBs), SGLT2 inhibitors, and tight glycemic control. UACR is also a powerful cardiovascular risk predictor—each doubling of UACR is associated with a 29% increase in cardiovascular mortality. Monitoring UACR allows clinicians to detect kidney damage early, guide treatment decisions, and track response to therapy.
Normale Referenzbereiche
| Gruppe | Bereich | Einheit |
|---|---|---|
| Normal | <30 | mg/g |
| Moderately increased (microalbuminuria) | 30–300 | mg/g |
| Severely increased (macroalbuminuria) | >300 | mg/g |
Referenzbereiche können je nach Labor variieren. Vergleichen Sie Ihre Ergebnisse immer mit den Bereichen Ihres Testlabors.
Was hohe UACR-Werte bedeuten
Häufige Ursachen
- Diabetic nephropathy (most common cause globally)
- Hypertensive nephrosclerosis
- Glomerulonephritis (IgA nephropathy, membranous, focal segmental glomerulosclerosis)
- Lupus nephritis
- Preeclampsia
- Heart failure
- Urinary tract infection (transient elevation)
- Intense exercise or fever (transient elevation)
- Obesity
Mögliche Symptome
- Usually asymptomatic in early stages
- Foamy or frothy urine (with significant proteinuria)
- Swelling in feet, ankles, or around eyes (nephrotic range)
- Fatigue
- Elevated blood pressure
Was zu tun ist: Elevated UACR should be confirmed with at least two of three specimens over 3–6 months, as transient causes (exercise, UTI, fever) can produce false positives. If persistently elevated, evaluate for underlying causes: check blood glucose and HbA1c (diabetes), blood pressure, serum creatinine and eGFR, serum albumin, and urinalysis for active sediment. Treatment focuses on the underlying cause and renoprotective measures: ACE inhibitors or ARBs reduce albuminuria and slow CKD progression, SGLT2 inhibitors provide additional renoprotection, and blood pressure and glycemic targets should be optimized.
Was niedrige UACR-Werte bedeuten
Häufige Ursachen
- Normal kidney function
- Effective treatment reducing albuminuria
Mögliche Symptome
- No symptoms associated with low UACR
Was zu tun ist: A UACR below 30 mg/g is normal and indicates intact glomerular filtration barrier function. Continue regular screening if risk factors are present (diabetes, hypertension). A reduction in UACR with treatment correlates with improved renal and cardiovascular outcomes.
Wann wird ein UACR-Test empfohlen?
- Annual screening in all patients with diabetes (type 1 after 5 years, type 2 at diagnosis)
- Annual screening in patients with hypertension
- Evaluation and staging of chronic kidney disease
- Monitoring response to renoprotective therapy (ACE inhibitor, ARB, SGLT2 inhibitor)
- Cardiovascular risk assessment
- Preeclampsia evaluation in pregnancy
Häufig gestellte Fragen
Verwandte Biomarker
Quellen- und Prüfungsansatz
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