Medically reviewed by Dr. Farhana Mukhtar, M.B.B.S., M.Phil (Pb.), Consultant Chemical Pathologist, Al-Nasar Lab & Diagnostic Centre. Updated November 2026.
Quick answer: A urine microalbumin test detects small amounts of albumin, a protein that healthy kidneys keep out of the urine. It is the earliest sign of kidney damage from diabetes and high blood pressure, appearing years before a blood creatinine test changes. Everyone with diabetes should have it at least once a year. It is reported either as a 24 hour collection or as an albumin to creatinine ratio (ACR) on a single sample.
Book a microalbumin test: call 0300 0341944, or arrange home sample collection across Lahore on 0309 1166944.
Why this test matters so much in diabetes
Diabetes is the leading cause of kidney failure, and Pakistan has one of the highest rates of diabetes in the world. Kidney damage from diabetes is silent. There is no pain and no change in urine you would notice.
The first sign is a small leak of albumin through the kidney’s filters. At that stage, good control of blood sugar and blood pressure, along with certain kidney protecting medicines, can slow or even partly reverse the damage.
By the time a kidney function test shows a raised creatinine, a large share of kidney function may already be lost. That is the whole case for microalbumin testing: it moves the warning several years earlier.
Who should be tested?
- Everyone with type 2 diabetes, from diagnosis and then every year
- People with type 1 diabetes, starting about five years after diagnosis, then yearly
- People with high blood pressure
- Anyone with chronic kidney disease or a family history of it
- People with heart disease, since albumin in the urine also signals higher cardiovascular risk
How the result is reported
| Category | ACR (mg/g) | 24 hour albumin (mg/day) | What it means |
|---|---|---|---|
| Normal | below 30 | below 30 | No significant leak |
| Moderately increased (previously called microalbuminuria) | 30 to 300 | 30 to 300 | Early kidney damage. Treatment can slow it |
| Severely increased | above 300 | above 300 | Established kidney damage needing specialist care |
Some laboratories report ACR in mg/mmol, where the equivalent cut off for moderately increased is about 3. Read the units and range on your own report.
One raised result is not a diagnosis
Albumin in the urine rises temporarily for many reasons that have nothing to do with kidney damage. Standard practice is to confirm a raised result with two of three samples abnormal over three to six months before labelling it as kidney disease.
Common causes of a temporary rise:
- Strenuous exercise in the previous 24 hours
- A urinary tract infection
- Fever or an acute illness
- Very high blood sugar or uncontrolled blood pressure at the time
- Menstruation, which contaminates the sample
Spot ACR or 24 hour urine?
The spot ACR uses a single sample, ideally the first urine of the morning. Measuring creatinine in the same sample corrects for how concentrated the urine is. It is convenient and is now the most commonly used method.
The 24 hour collection measures all albumin passed in a full day. It is more cumbersome, and errors in collection are common, but some doctors still request it. If yours does, the laboratory will give you a container and instructions: discard the first urine of the morning, then collect every drop for the next 24 hours including the first urine of the following morning.
What helps if albumin is raised
Your doctor will decide treatment, which usually focuses on:
- Tighter blood sugar control, checked with HbA1c
- Blood pressure control, often with ACE inhibitors or ARBs, which also protect the kidney directly
- Newer diabetes medicines with kidney protective effects, where suitable
- Stopping smoking and reducing salt
- Avoiding regular use of painkillers such as ibuprofen and diclofenac without medical advice
How to prepare
- For a spot ACR, use the first urine of the morning where possible
- Avoid strenuous exercise for 24 hours beforehand
- Postpone if you have a fever, urinary infection or your period
- No fasting is needed
- Bring previous results so the trend is visible
Microalbumin testing at Al-Nasar Lab
Al-Nasar Lab & Diagnostic Centre has provided laboratory testing in Lahore since 1996 and holds ISO 15189:2022 accreditation from the Pakistan National Accreditation Council. Urine microalbumin, HbA1c, kidney function and lipid testing are all available, with home sample collection across Lahore, so a full yearly diabetes review can be done from one visit. See our guide to blood sugar testing.
See our accreditations, find your nearest collection centre, or contact us to book.
Frequently Asked Questions
What is a normal urine microalbumin level?
An albumin to creatinine ratio below 30 mg/g, or below 30 mg in a 24 hour collection.
How often should people with diabetes have this test?
At least once a year, starting at diagnosis for type 2 diabetes.
Can exercise affect the result?
Yes. Strenuous exercise in the previous 24 hours can raise albumin temporarily. Avoid it before the test.
Is microalbuminuria reversible?
At the early stage it can often be slowed and sometimes reduced with good sugar and blood pressure control and kidney protecting medicines.
Do I need a 24 hour urine collection?
Usually not. A single morning sample tested for ACR is the common method, though some doctors request a 24 hour collection.
This article is for general information and is not a substitute for medical advice. Please discuss your results with a qualified doctor.
