What Does Albumin in Your Urine Indicate?

Albumin is a type of protein that circulates in your blood. When high levels of albumin appear in your urine, it can be a sign of kidney disease. Learn how doctors test for albumin and what the results can mean.

Most people have trace amounts of protein in their urine, but significant levels of proteins can be a red flag.

Proteinuria is a general term used to describe the presence of multiple types of protein in your urine. Albumin is a specific type of protein, and albuminuria develops when you have high levels of albumin in your urine.

Albuminuria can develop for a variety of reasons, but kidney problems are one of the most common. Find out who develops albuminuria and what to expect if you have higher-than-normal levels of albumin in your urine.

Albumin is a type of protein made up of amino acids. It helps move hormones, nutrients, and enzymes throughout your body via your bloodstream. Albumin is the most common type of protein in your blood, making up about half of the total proteins found in your body.

Albumin is produced in your liver and is mostly stored and used in your blood. It can be found in other body fluids, including urine, but large amounts of albumin outside of the bloodstream are often a sign of a problem.

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What is albuminuria?

Albuminuria is the term doctors use to indicate too much albumin in your urine. It’s often a sign of kidney disease because healthy kidneys don’t typically allow albumin to pass from your blood into your urine.

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Albuminuria is usually caused by a problem with your kidneys. Your kidneys filter your body fluids, removing valuable nutrients and moving them back into the body and turning waste particles into urine.

When the filtration system in your kidneys isn’t working well, too much protein can move into your urine.

Chronic kidney disease is one of the main issues that can lead to proteinuria or albuminuria. Those at risk of developing chronic kidney disease include people with:

• diabetes
• high blood pressure
• a family history of chronic kidney disease

People over the age of 65 and those with certain racial or ethnic backgrounds — such as African Americans, Hispanic people, and Native Americans — also have an increased risk of kidney diseases.

You may also have an acute (temporary) kidney injury that can cause albumin to pass into your urine. Albuminuria can also signal a higher risk of developing various cardiovascular diseases.

Does having albuminuria mean you have kidney disease?

Healthy kidneys don’t allow large amounts of albumin to pass into your urine. Some temporary kidney problems like an acute kidney injury caused by some illnesses or medications may result in albuminuria, but the presence of proteins like albumin in the urine is often a sign of more chronic kidney disease.

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If you have a history of high levels of albumin in your urine or you’ve been diagnosed with a chronic kidney disease, your doctor will want to check the levels of albumin and other proteins in your urine regularly.

Monitoring the albumin and other protein levels in your urine can help your doctor or kidney specialist, called a nephrologist, monitor the progression of your disease and the effectiveness of any treatments.

A variety of urine tests are usually performed during your routine health screenings, but your doctor may want to check your urine more often if you’re diagnosed with kidney disease.

A one-time test showing albumin in your urine may not be enough to warrant a diagnosis of kidney disease. Your doctor will probably want to repeat urine testing once or twice more to see whether albumin continues to be found in your urine sample.

If you have chronic kidney disease, the ongoing schedule for urine testing will depend on how your kidney disease is being treated, the stage and severity of your kidney disease, and what other health conditions you might have.

Screening for albuminuria in people with diabetes

Albuminuria can be a complication of chronic hyperglycemia (high blood sugar) due to uncontrolled diabetes. Medical guidelines recommend that people with type 1 diabetes be checked for albuminuria 5 years after their diagnosis and annually thereafter.

For those with type 2 diabetes, guidelines recommend screening at diagnosis and annually thereafter. This is crucial because prompt use of certain medications, including angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs), can decrease albuminuria and the progression of kidney disease.

The albumin levels in your urine are checked with a simple urine sample. No special collection or preparation is necessary before this test, and only about 2 tablespoons of urine are needed.

Once collected, your urine can be tested for albumin and other proteins in two ways:

• Dipstick test: A dipstick test uses a plastic testing strip coated with a reactive material that will immediately indicate the presence of albumin when placed in the urine sample.
• Laboratory testing:Lab testing can also be done to examine your urine under a microscope. This test is usually referred to as the albumin-to-creatinine ratio (ACR) test. While a simple urine collection can be used, your healthcare professional may want to do a 24-hour urine collection.

What do my results mean?

Two tests over a period of three months that show elevated albumin levels in the urine usually indicate a problem. A dipstick test will indicate the presence of albumin but won’t give you any information about specific amounts.

The following ranges are used to rank albumin levels found through laboratory testing of urine:

• Normal to mildly increased: ACR greater than 30 mg/g
• Moderately increased: ACR between 30 and 300 mg/g
• Severely increased: ACR of 300 mg/g or more

ACR levels in the moderately increased range for 3 months indicate chronic kidney disease. An ACR greater than 2,000 mg/g can be a sign of a more serious issue, such as nephrotic syndrome.

Anything less than 30 mg/g is considered normal.

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If you have elevated levels of albumin in your urine but you haven’t yet been diagnosed with chronic kidney disease, you can try these lifestyle tips to resolve your albuminuria and boost your kidney health:

• Eat a nutritious, balanced diet.
• Maintain a moderate range.
• Monitor your salt and sodium intake.
• Stay active and exercise regularly.
• Be mindful of how much and what types of proteins you eat.
• Use of ACE inhibitors and ARBs as recommended by your doctor.
• Review with your doctor any other medications you’re taking regularly.

If you’re diagnosed with chronic kidney disease, your nephrologist will discuss diet and lifestyle changes you may need to make, as well as medications and other treatments. Early treatments to reduce albuminuria can include medications to lower your blood pressure.

In more advanced stages of kidney disease, you may need to follow a special diet, restrict your fluid intake, or undergo dialysis treatments or a kidney transplant.

Tiny amounts of proteins like albumin can be found in your urine, but albumin levels above a certain threshold are typically a sign that your kidneys aren’t working properly.

Your doctor may recommend testing your urine regularly at health screenings, especially if you have certain risk factors for developing chronic kidney disease.

Last medically reviewed on April 14, 2023