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Urine Alpha-1-Microglobulin-to-Creatinine Ratio

Published: August 9, 2026Updated: August 16, 2026

This urine test measures alpha-1-microglobulin relative to creatinine to help assess kidney tubule damage and response to treatment.

Quick summary

["The result can help detect early kidney tubule injury, particularly in people with diabetes or hypertension."]

Medically reviewed by WellAlly Editorial TeamLast reviewed August 16, 2026Editorial policy

Key facts at a glance

LOINC
48415-4
Short code
A1 Microglob/Creat Ur
Synonyms
A1 Microglob/Creat Ur
Category
liver
Sample
urine
Container
Sterile urine container
Units
N/A
Fasting
false
Population
adult
Sex
all
Age range
18–65 years
Specimen volume
10 mL
Stability
Room temperature: 2h, Refrigerated: 24h, Frozen: 7d
Hemolysis max
0
Lipemia max
0
Icterus max
0
TAT
4–24 hours
Order
routine

What is this test?

This test measures the amount of alpha-1-microglobulin in urine compared with the amount of creatinine. Alpha-1-microglobulin is a small protein that is normally filtered by the kidneys and reabsorbed in the tubules. The ratio helps evaluate how well the kidney tubules are handling this protein.

Why might I need this test?

Your clinician may order this test to look for early kidney tubule damage, monitor chronic conditions such as diabetes or hypertension, or assess the effects of certain medicines. It may also be used alongside urine albumin testing and estimated glomerular filtration rate.

How is the test performed?

A urine sample is tested to determine the urine alpha-1-microglobulin and creatinine concentrations, and the two values are used to calculate the ratio. The result is reported as a mass ratio rather than as a concentration alone.

How do I prepare for the test?

Follow your clinician's or laboratory's collection instructions. A first-morning urine sample is often used, and a clean-catch midstream sample may be requested. Tell the healthcare team if you recently had intense exercise, a urinary infection, or an episode of markedly high blood glucose, because these can affect the result.

Clinical interpretation

How abnormal results are interpreted and what conditions they suggest.

◆Associated findings1

Short name

Urine A1M/Creatinine Ratio

Frequently asked questions

What does the alpha-1-microglobulin-to-creatinine ratio measure?
It measures the relative amount of alpha-1-microglobulin and creatinine in urine. Dividing by creatinine helps reduce the effect of differences in urine concentration.
What does a high result suggest?
A high result may suggest kidney tubule damage or impaired reabsorption of small proteins. It can be seen with conditions such as diabetes, hypertension, or exposure to certain medicines.
Is this the same as a urine albumin-to-creatinine ratio?
No. This test measures alpha-1-microglobulin, which primarily helps evaluate kidney tubule function, while the urine albumin-to-creatinine ratio is mainly used to assess kidney filtering injury and cardiovascular risk.
  1. 1
    MedlinePlus — Laboratory TestsSource
  2. 2
    Lab Tests OnlineSource
  3. 3
    Mayo Clinic — Tests & ProceduresSource

Click any link to access the full source. PubMed Central (PMC) links provide free full-text access.

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.

Medical Disclaimer

This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.

If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.

Medically reviewed by WellAlly Editorial Team Last reviewed August 16, 2026. · Read our editorial policy