Heart Health

Urine albumin worth measuring

Urine albumin (UACR)? Not measured, with diabetes, prediabetes, eGFR below 60, BP medication, or BP 130/80 or above

Testalbuminuria-not-measuredFewer than 5 people have reached this rule so far

Ask for the test — a normal eGFR does not rule it out

Clinical review

All reviewers

No clinician has signed off this rule yet. It reflects our reading of the guidelines cited below, which has not been independently checked.

What someone who reaches this rule is told

Word for word, as generated for the example person below. Figures in the text are theirs.

  • A test worth considering

    Ask for a urine albumin-to-creatinine ratio. It's a single urine sample, most people at your risk level have never had one, and a normal eGFR doesn't rule it out.

    Kidney damage shows up in two independent ways: filtration slowing down (eGFR) and protein leaking out (albumin). They don't move together, so it's entirely possible — and common with diabetes, prediabetes, or treated blood pressure — to have a perfectly normal eGFR and meaningful protein loss at the same time. Finding it changes what you're prescribed and lowers your blood pressure target, and finding it early is when those changes do the most good.

    Guideline consensusRecommended by the guideline writing committee, drawing on trials plus expert judgement where trials run out.· checked 2026-09-12

    KDIGO Clinical Practice Guideline for the Evaluation and Management of CKD · Test — worth asking for

An example person who reaches it

Borderline risk + high Lp(a)” — an illustrative profile, not a real user.

58-year-old manBP 132/82LDL 140Lp(a) 78 mg/dL10-yr PREVENT-ASCVD 4.9%

Their path through prevention essentials

  1. Known cardiovascular disease?No
  2. On a statin, or is one indicated?Yes
  3. Urine albumin (UACR)?Not measured, with diabetes, prediabetes, eGFR below 60, BP medication, or BP 130/80 or above ← this rule

Sources

Cited by the recommendations above.

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Runs in lib/engine/preventionEssentials.ts as albuminuria-not-measured.