This test detects the amount of albumin (a type of protein) in the urine in a day. The American Diabetes Association recommends ACR as the preferred test for screening for even small amounts of albumin in the urine (this is called microalbuminuria)⁷.

Measurement of urine protein and albumin can be done as spot tests on a small sample or as tests on all the urine collected by a person for a full 24 hours. Though it is burdensome to collect urine for 24 hours this is sometimes needed to give the most accurate information on the kidney function.

Also, as part of the examination, your doctor should measure your blood pressure and order a blood test to measure the levels of glucose and creatinine in your blood. We will explain this further in the next section.

Using the blood creatinine concentration, age, body size and gender the doctor can calculate the eGFR for a patient. 

The eGFR is the best test available to estimate the kidney function and to define the stage of the disease. It also allows for the monitoring of the disease progression and to plan it’s treatment accordingly. 

Remember that the earlier the CKD is diagnosed the better the chances of slowing or stopping its progression.

The value of the eGFR decreases as kidney disease progresses: a lower eGFR score means that there is more damage to the kidneys and their function is lower.

eGFR can also be calculated using the concentration of another protein called cystatin C.

The level of circulating creatinine in the blood is a marker for kidney function. Creatinine is a waste product from activities of muscle fibers, and is normally filtered and removed from the blood by the kidneys. When the kidneys function worsens the creatinine serum levels rise. 

Serum creatinine is also used in the eGFR calculation.

A normal waste product from the breakdown of proteins in the food we eat and a byproduct of the body's metabolism, urea nitrogen is normally removed from the blood by the kidneys.

BUN levels rise when kidney function worsens. It can also rise or decrease depending on the amount of protein in your diet.

Albumin is a type of protein that normally circulates in the blood. It's made from the protein we consume in our diet. Usually, albumin is too big to be filtered by the kidneys but when the kidney damage is severe enough a patient may start losing albumin from the blood through the kidneys. Low levels of albumin may lead to several health problems including problems fighting infections. Since albumin attracts liquid and keeps it in the blood vessels, a low level of albumin might lead also to fluid retention and generalized swelling.

The level of albumin in the blood is also affected by the amount of protein in your diet.

Hemoglobin is the chemical compound of the red blood cells that carries the oxygen from the lungs to every cell in the body. 

The hemoglobin levels let your doctors know if you have anemia which is when the hemoglobin levels fall below normal values. Anemia can make you feel tired, with low energy, palpitations, agitated and may also increase the risk of infections²

Cholesterol is normally found in your blood. A high cholesterol level may increase your chance of having heart and circulation problems. For many patients, a good level for total cholesterol is below 200. If your cholesterol level is too high, your doctor may ask you to make some changes in your diet and increase your activity level. In some cases, medications to lower the cholesterol levels are also used.

In adults with newly identified CKD (including those treated with chronic dialysis or kidney transplantation), an evaluation with a series of exams is recommended to determine “the lipid profile” that involves measuring the level of cholesterol and other fatty substances in the blood. (total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides)⁶