- Select the unit — mg/g or mg/mmol — to match how your lab reports UACR. Switching units re-scales the category thresholds automatically.
- Enter each measurement on its own row: an optional date / label and the UACR value. Enter readings oldest → newest (top row is the earliest visit).
- Leave unused rows blank — blank rows are ignored. You need at least one value; trend and percent change need at least two.
- The results table shows each reading in order with its KDIGO albuminuria category (A1/A2/A3) and a trend arrow versus the previous reading.
- The summary cards show the latest UACR, the latest category, and the overall percent change from the first to the latest reading; the verdict flags category crossings and meaningful change.
All computation runs in your browser; no values are stored or transmitted.
When to Use
Use this tracker when you have more than one UACR result for a patient and want to see the longitudinal trajectory — not just a single point-in-time KDIGO albuminuria category. Albuminuria is both a marker of kidney damage and an independent, modifiable driver of CKD progression and cardiovascular risk, so the direction and magnitude of change over time often matter more than any one value.
Typical uses
Monitoring response to renin–angiotensin system (RAAS) blockade, SGLT2 inhibitors, or finerenone; surveillance of diabetic or hypertensive kidney disease; tracking glomerular disease activity; and confirming whether an abnormal screening UACR represents persistent albuminuria. A sustained reduction in albuminuria is a validated surrogate for slowed kidney-function decline.
Confirm persistence before acting
A single abnormal UACR is not a diagnosis. KDIGO defines persistent albuminuria as ≥2 of 3 abnormal samples over 3–6 months. Use an early-morning (first-void) sample where possible, and account for pre-analytic variability — vigorous exercise, fever, urinary-tract infection, menstruation, decompensated heart failure, and very high protein intake can all transiently raise UACR.
Pearls & Pitfalls
Track the trend, treat to lower it
A ≥30% reduction (or halving) in UACR after starting an antiproteinuric agent is a recognised early signal of treatment response and predicts slower long-term GFR decline. Lowering albuminuria is a validated surrogate endpoint for kidney outcomes — falling numbers are a goal, not just a finding.
Watch the category crossings
Crossing from A1→A2 or A2→A3 carries real prognostic weight in the KDIGO heat map, independent of GFR category. A ≥30% rise (or doubling) suggests worsening; investigate adherence, blood-pressure and glycaemic control, intercurrent illness, and the need to intensify therapy.
Pitfalls
(1) UACR varies substantially day-to-day — don't over-interpret a single change without a confirmatory sample. (2) Spot UACR can differ from a timed 24-hour albumin collection; be consistent in method. (3) Very low muscle mass lowers urine creatinine and can spuriously raise the ratio; the opposite occurs with high muscle mass. (4) UTI, menstruation, fever, exercise, and heart-failure decompensation cause transient elevations — interpret in context.
Why Use It
A one-off UACR tells you the current KDIGO albuminuria category; a trend tells you whether the kidney disease is progressing, stable, or responding to therapy. Because change in albuminuria is an accepted surrogate for kidney outcomes, serial tracking converts a static lab value into an actionable signal: a meaningful fall validates the current regimen, a meaningful rise or a category crossing prompts you to look for a cause and intensify treatment. Laying the readings side-by-side with their categories and arrows makes that trajectory immediately visible.
UACR Serial Trend Tracker
Enter up to six dated measurements oldest → newest (top row first). The table shows each reading's KDIGO albuminuria category and the trend versus the previous visit; the cards summarise the latest value, latest category, and overall percent change. Blank rows are ignored.
⚕ KDIGO albuminuria categories: A1 <30 mg/g (<3 mg/mmol) normal–mildly increased; A2 30–300 mg/g (3–30 mg/mmol) moderately increased; A3 >300 mg/g (>30 mg/mmol) severely increased. Unit conversion: mg/mmol = mg/g ÷ 8.84. Trend arrows and percent change are visit-to-visit relative to the readings you enter; this is an educational tracking aid, not a diagnosis. Source: KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of CKD. Kidney Int. 2024;105(4S):S117–S314.
Next Steps
Use the trend to support — not replace — clinical judgment.
- Confirm persistent albuminuria with ≥2 of 3 abnormal samples over 3–6 months before labelling a category; prefer early-morning samples.
- If UACR is rising or has crossed into a worse category, review adherence, blood-pressure and glycaemic control, intercurrent illness (UTI, fever), and whether to start or intensify RAAS blockade, an SGLT2 inhibitor, or finerenone.
- If UACR has fallen ≥30%, document the treatment response and continue the regimen; a sustained reduction predicts slower kidney-function decline.
- Interpret alongside eGFR trend, blood pressure, and the KDIGO GFR-by-albuminuria heat map; refer to nephrology for progressive, severe (A3), or unexplained albuminuria.
Evidence & References
KDIGO albuminuria categories
| Category | UACR (mg/g) | UACR (mg/mmol) | Term |
|---|---|---|---|
| A1 | < 30 | < 3 | Normal to mildly increased |
| A2 | 30 – 300 | 3 – 30 | Moderately increased |
| A3 | > 300 | > 30 | Severely increased |
Interpreting change
| Change from first → latest | Interpretation |
|---|---|
| ≥ 30% decrease (or halving) | Likely treatment response (RAAS blockade / SGLT2i / finerenone); a validated surrogate for slowed CKD progression |
| Within ±30%, same category | Broadly stable — continue monitoring |
| ≥ 30% increase (or doubling) | Suggests worsening — review adherence, BP, glycaemia, and intercurrent illness |
| Category crossing (A1→A2, A2→A3) | Clinically meaningful progression independent of GFR — investigate and intensify therapy |
Conversion: mg/mmol = mg/g ÷ 8.84. UACR has appreciable biological and pre-analytic variability; confirm meaningful changes with a repeat early-morning sample before changing management.
Evidence & References
KDIGO classifies albuminuria into A1/A2/A3 by UACR and combines it with the GFR category in the prognostic CKD heat map. Change in albuminuria is widely accepted as a surrogate endpoint for kidney outcomes, supporting serial UACR tracking to gauge progression and treatment response.
- Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int. 2024;105(4S):S117–S314.
- Heerspink HJL, Greene T, Tighiouart H, et al. Change in albuminuria as a surrogate endpoint for progression of kidney disease: a meta-analysis of treatment effects in randomised clinical trials. Lancet Diabetes Endocrinol. 2019;7(2):128–139.
- Levey AS, Gansevoort RT, Coresh J, et al. Change in albuminuria and GFR as end points for clinical trials in early stages of CKD. Am J Kidney Dis. 2020;75(1):84–104.
