Person—kidney damage marker, urine albumin/creatinine ratio N[NN].N
Identifying and definitional attributes
|Metadata item type:||Data Element|
|Short name:||Kidney damage marker (urine albumin/creatinine ratio)|
The ratio of albumin to creatinine in a person's urine, used to detect kidney damage, measured in milligrams per millimole.
Public health, health care and clinical settings.
|Data Element Concept:||Person—kidney damage marker|
Value domain attributes
|Maximum character length:||4|
|Unit of measure:||Milligram per millimole (mg/mmol)|
|Unit of measure precision:||1|
Data element attributes
Collection and usage attributes
|Guide for use:|
Testing for elevated albumin in the urine (albuminuria) is used to evaluate kidney damage. Urine albumin/creatinine ratio (ACR) tests assess single urine samples to detect both the albumin and creatinine (a byproduct of muscle metabolism which is normally released into the urine at a constant rate). The urine albumin level varies throughout the day with more or less liquid being released in addition to the body's waste products. Urine ACR tests assess urine creatinine levels in conjunction with albumin which allows the measurement to be corrected for urine concentration.
The preferred method for assessment of kidney damage in both diabetic and non-diabetic individuals is urinary ACR measurement in a first-void (first morning) spot specimen. A positive test should be repeated to confirm persistence of albuminuria. Chronic kidney disease (CKD) is present if 2 out of 3 tests (including the initial test) are positive. If the first positive urine specimen is a random spot test (as it may be for opportunistic testing), then repeat tests should ideally be first morning void specimens.
Laboratory findings for urine ACR tests are reported as the ratio of albumin to creatinine measured in milligrams per millimole.
Urine albumin level can be used to detect kidney damage and increased renal and cardiovascular disease risk. Urine albumin levels which are higher than laboratory reference ranges are used to determine the level of kidney damage: normal albumin excretion (normoalbuminuria), moderate albumin excretion (microalbuminuria), and severe albumin excretion (macroalbuminuria). The reference range for determining albuminuria using ACR can be found in the Kidney Health Australia Caring for Australasians with Renal Impairment (KHA-CARI) CKD guidelines.
Source and reference attributes
Australian Institute of Health and Welfare (AIHW)
Kidney Health Australia (KHA) 2012. Caring for Australasians with Renal Impairment (CARI) Guidelines. Diagnosis, classification and staging of chronic kidney disease. Sydney: KHA. Viewed 20 October 2015, http://www.cari.org.au/CKD/CKD%20
|Related metadata references:|
See also Person—kidney damage marker (urine albumin level), total milligrams per 24 hours N[NNN].N
See also Person—kidney damage marker (urine protein level), total milligrams per 24 hours N[NNN].N
See also Person—kidney damage marker, protein/creatinine ratio N[NN].N
Supersedes Person—microalbumin level (measured), albumin/creatinine ratio N[NN].N
|Implementation in Data Set Specifications:|
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