Urine albumin (UACR)? 30 mg/g or above
albuminuria-presentNo one has reached this rule yetACE inhibitor or ARB first; SGLT2 inhibitor conditional to 200 mg/g and recommended above it or with heart failure
No clinician has signed off this rule yet. It reflects our reading of the guidelines cited below, which has not been independently checked.
Word for word, as generated for the example person below. Figures in the text are theirs.
You're leaking protein into your urine (60 mg/g). Take that number to your doctor and ask what it changes about your treatment.
This is worth being concrete about. Albuminuria is kidney damage measurable before filtration falls, and it raises cardiovascular risk independently — people with protein in the urine have more heart attacks and strokes at every level of kidney function. It typically changes three things: an ACE inhibitor or ARB to reduce the leak, a lower blood pressure target, and — above roughly 200 mg/g or alongside heart failure — an SGLT2 inhibitor, which protects both organs whether or not you have diabetes. We stop short of saying which you should be on, because that depends on your potassium and kidney function together with everything else you take. Also ask for a repeat sample: one reading can be raised by infection, hard exercise, or a fever.
Why this is a question, not a recommendation. Being more specific would need a recent potassium level, everything else you're currently taking. That isn't something this tool asks for, so this one stays a question.
Outcome-provenTested in randomised trials measuring heart attacks, strokes, or death, not a stand-in for them.· Class I· Level A· checked 2026-09-12
KDIGO Clinical Practice Guideline for the Evaluation and Management of CKD · Class I
“Heart failure with a weak pump” — an illustrative profile, not a real user.
Cited by the recommendations above.
For practising clinicians. Endorse it, propose a change, or dispute it. We verify every reviewer before a review is shown, and a review stays attached to the version of the rule you saw — if the rule changes, the page says so. You'll be asked to declare any relevant interests; they're shown with your review.
Log in or create an account to submit a review. An account is how we tie a review to a person we can verify.
Runs in lib/engine/preventionEssentials.ts as albuminuria-present.