Why It Is Done

This test is done to check for albumin in the urine. Finding it early may change treatment so a person will keep as much kidney function as possible.

Sometimes an albumin-creatinine ratio test is also done. This urine test compares the amount of albumin with the amount of a waste product called creatinine (say “kree-AT-uh-neen”). The test can help give a more accurate measure of albumin levels. This is because the amount of albumin can change, depending on how much water is in your urine. But creatinine levels tend to stay the same.

How To Prepare

You do not need to do anything special to prepare for this test.

How It Is Done

For a random urine test, you will provide a clean-catch midstream urine sample. A morning urine sample gives the best information about albumin levels.

Clean-catch midstream one-time urine collection

• Wash your hands to make sure they are clean before you collect the urine.
• If the collection cup has a lid, remove it carefully. Set it down with the inner surface up. Do not touch the inside of the cup with your fingers.
• Clean the area around your genitals.
  • For men: Pull back the foreskin, if you have one. Clean the head of the penis thoroughly with medicated towelettes or swabs.
  • For women: Spread open the folds of skin around the vagina with one hand. Then use your other hand to clean the area around the vagina and urethra thoroughly with medicated towelettes or swabs. Wipe the area from front to back to avoid spreading bacteria from the anus to the urethra.
• Start urinating into the toilet or urinal. Women should keep holding apart the folds of skin around the vagina while they urinate.
• After the urine has flowed for several seconds, place the collection cup into the stream. Collect about2 fl oz (60 mL) of this “midstream” urine without stopping the flow.
• Do not touch the rim of the cup to your genital area. And don’t get toilet paper, pubic hair, stool (feces), menstrual blood, or other foreign matter in the urine sample.
• Finish urinating into the toilet or urinal.
• Carefully replace the lid on the cup. Return the cup to the lab. If you are collecting the urine at home and can’t get it to the lab in an hour, refrigerate it.

A urine sample collected over time, such as over 4 or 24 hours, gives the most accurate results. So you may be asked to collect your urine over a specific time period.

Timed urine collection (24 hours)

• You start collecting your urine in the morning. When you first get up, empty your bladder but do not save this urine. Write down the time that you urinated. This marks the beginning of your 24-hour collection period.
• For the next 24 hours, collect all your urine. Your doctor or lab will usually provide you with a large container that holds about1 gal (4 L). The container has a small amount of preservative in it. Urinate into a small, clean container, and then pour the urine into the large container. Do not touch the inside of either container with your fingers.
• Keep the large container in the refrigerator for the 24 hours.
• Empty your bladder for the final time at or just before the end of the 24-hour period. Add this urine to the large container, and record the time.
• Do not get toilet paper, pubic hair, stool (feces), menstrual blood, or other foreign matter in the urine sample.

How It Feels

This test does not cause any pain.

What Affects the Test

You may not be able to have the test, or the results may not be helpful, if:

• You have a urinary tract infection, high blood pressure, heart failure, or a high fever during an infection.
• You exercise just before the test.
• You take medicines such as aspirin, corticosteroids, or some antibiotics, such as amoxicillin.
• You have menstrual bleeding or vaginal discharge. These may temporarily affect the urine sample.

What To Think About

• The American Diabetes Association recommends three tests to check for kidney damage. These tests are blood pressure, urine albumin, and a creatinine blood test to calculate an estimated glomerular filtration rate (eGFR). Creatinine is a waste product that is filtered out of the blood by healthy kidneys. To learn more, see the topic Creatinine and Creatinine Clearance.
  • If you have type 2 diabetes, you should have these tests when you are first diagnosed. Then have them each year to check for diabetic nephropathy.
  • If you have type 1 diabetes, you should have these tests to check for diabetic nephropathy each year, starting 5 years after diagnosis.
  • If you have either type of diabetes and are pregnant, talk to your doctor about how often you need to be tested.
• The urine dipstick test can be used to check for albumin in a single sample of urine. But the dipstick test is not as accurate a test for finding albuminuria as the urine test. It is not recommended in place of an albumin urine test.