Urine albumin-to-creatinine ratio (ACR) is used to screen for which diabetes-related issue?

• A. Kidney involvement including microalbuminuria
• B. Liver disease
• C. Neuropathy
• D. Cardiac arrhythmia

Answer: (A)

In diabetes, kidneys can gradually become damaged, and the earliest sign is small amounts of albumin spilling into the urine. The urine albumin-to-creatinine ratio (ACR) is used to screen for this kidney involvement because it measures how much albumin is present relative to creatinine in a single urine sample, which normalizes for how dilute or concentrated the urine is. A higher ratio indicates increased glomerular permeability and early diabetic nephropathy, often detected before other kidney function tests show problems. Detecting microalbuminuria early is important because it invites timely interventions—like tighter glucose control and blood pressure management with agents such as ACE inhibitors or ARBs—to slow progression to more serious kidney disease. This test specifically screens for kidney involvement, not for liver disease, neuropathy, or heart rhythm issues, which are assessed with different tests.