The Albumin-Creatinine Ratio (ACR) is a urine test that measures the amount of albumin (a protein) compared to creatinine (a waste product) in your urine. It is a sensitive marker for early kidney damage, especially in diseases like diabetes and hypertension.

📊 Formula:

$$\text{ACR} = \frac{\text{Urine albumin (mg)}}{\text{Urine creatinine (g)}}$$

• Units: mg/g or mg/mmol (depends on the country/lab)

🔍 Why ACR is Important:

✅ Standard screening tool for detecting microalbuminuria
✅ Helps assess early kidney damage before full-blown nephropathy occurs
✅ Allows early intervention in patients at risk (diabetes, hypertension, CKD)

🔬 Interpretation:

📌 Clinical Significance:

• Diabetes: ACR is part of annual screening for diabetic nephropathy

• Hypertension: Elevated ACR may reflect vascular or renal injury

• Chronic Kidney Disease (CKD): ACR helps in staging and monitoring

• Cardiovascular Risk: Even mildly elevated ACR is associated with higher CV risk

🧠 Example:

🔹 A diabetic patient has:

• Urine albumin = 40 mg

• Urine creatinine = 1 g

$$ACR = \frac{40}{1} = 40\, \text{mg/g} \Rightarrow \text{Microalbuminuria}$$

→ Action: Intensify glucose/BP control, consider ACE inhibitors/ARBs.