Urine Albumin-to-Creatinine Ratio (uACR)
Last reviewed 25 August 2026 · Evidence-graded review — see Methodology
A urine test, not a blood test, and the one most often missing from a premium panel that already contains forty blood markers. Albumin leaking into the urine is an early sign of kidney damage and, independently of kidney function itself, one of the strongest available predictors of cardiovascular death. It moves years before creatinine or eGFR do, and it costs about the same as a full blood count.
Matsushita K, Coresh J, et al. (Chronic Kidney Disease Prognosis Consortium) “Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis.” Lancet 2010;375:2073–2081 pooled 21 general-population cohorts covering more than 1.2 million participants and found that albuminuria predicted all-cause and cardiovascular mortality independently of eGFR, across the entire range of kidney function. KDIGO stages chronic kidney disease on eGFR and ACR together, and the ACR is what decides whether an ACE inhibitor, ARB or SGLT2 inhibitor is indicated — an abnormal result with a direct, well-defined path to changed treatment.
Matsushita K, et al. Lancet. 2010. PubMed: PMID 20483451
Singapore guidance
Not covered in the current review
Singapore’s national screening committee has not reviewed this test in the current volume of its report, which covers nine conditions. That is not a verdict either way.
Source: Screening Test Review Committee report 2026, Volume 1 (Academy of Medicine Singapore and Ministry of Health, February 2026). The full national list · How this is used.
What you would actually pay
- Healthier SG
- Not subsidised
- MediSave
- Not among the screenings named for outpatient claims
Source: Healthier SG Screening (HealthHub) and MediSave outpatient care (Ministry of Health). Absence from either list is not a statement that the test is discouraged — only that no subsidy or claim applies. Gross prices compared.
What it costs when it is wrong
- Basis
- No published harm criterion found
- Severity
- Not documented
Not covered in the current volume of the committee’s report, so no harm criterion was found either way.
An empty finding, not a clean bill of health: this means nothing documented was found for this test. It is not a claim that the test is safe.
Screening harm is not only a laboratory question: the committee’s own criteria advise against a test when “the screening test, or follow-up tests arising from a positive screen, are associated with significant medical risks”. Sources on overdiagnosis → · How this is graded.
FAQ
Is the Urine Albumin-to-Creatinine Ratio (uACR) worth doing in Singapore?
For adults without symptoms, Urine Albumin-to-Creatinine Ratio (uACR) sits at the strong grade on our evidence scale. It is most appropriate for everyone — particularly anyone with diabetes, hypertension, or a family history of kidney disease. It typically costs S$15–30 in Singapore. The usual schedule: annually with diabetes, hypertension or known CKD; otherwise once as a baseline.
Weighing this against something else? Compare it with two other tests → · Price it inside a panel →