4727.0.55.002 - Australian Aboriginal and Torres Strait Islander Health Survey: Users' Guide, 2012-13  
ARCHIVED ISSUE Released at 11:30 AM (CANBERRA TIME) 10/09/2014  First Issue
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The Albumin/Creatinine ratio (ACR) test result is the ratio of measured albumin (a protein) and creatinine (a metabolism by-product) in the urine that has been excreted from the body, at the time of the test (spot sample). Creatinine is produced by the body at a constant rate, depending on muscle mass, and is removed by the kidneys. If the kidneys do not have adequate filtering capabilities (impaired kidney function), creatinine levels rise in the body and albumin can leak into the urine, and this is referred to as albuminuria.1 The severity of ACR levels, or albuminuria, is indicated as microalbuminuria and macroalbuminuria. which refers to impaired kidney function, and normoalbuminuria referring to normal ACR levels (adequate kidney function).2


Albumin and creatinine results were obtained for persons aged 18 years and over, who participated in the National Aboriginal and Torres Strait Islander Health Measures Survey (NATSIHMS) and who provided a urine sample. Fasting was not required for this test.


A urine sample was collected from participants and urinary albumin and creatinine levels were measured at the Douglass Hanly Moir (DHM) laboratory.

In the NATSIHMS, cut off reference values for albuminuria were sourced from the chronic disease position statement put out by the Medical Journal of Australia and the Chronic Kidney Disease (CKD) management guidelines by Kidney Health Australia.2,3 These guidelines are based on epidemiological data and publications of major clinical trials.

In the NATSIHMS, the following definitions were used for albuminuria (ACR levels):

Cut off points for Albuminuria (ACR) in the NATSIHMS

ACR levels for females
ACR levels for males

Normoalbuminuria (Normal)<2.5<3.5
Microalbuminuria2.5 to <25.03.5 to <35.0

Further test information about the analysis method and machine used to measure ACR levels is available in Excel spreadsheet format in the Downloads page of this product.

Data items

The data items and related output categories for this topic are available in Excel spreadsheet format from the Downloads page of this product.


Points to be considered when interpreting data for this topic include the following:
  • ACR test results do not confirm a specific diagnosis without consultation with a health professional.
  • There are a number of different test methods for measuring urine albumin and creatinine, which may produce different results. The data from this topic should therefore be used with caution when comparing ACR results from other studies using a different test method or equation.
  • Factors such as urinary tract infections, high protein diet intake or heavy exercise within 24 hrs are known to affect ACR results (other than chronic kidney disease).3 As a result, the data should be interpreted with care.

Comparability with other surveys

The NATSIHMS is the first ABS Aboriginal and Torres Strait Islander survey to collect biomedical information. Given it was also the first national level survey (ABS or otherwise) to collect such data for the Aboriginal and Torres Strait Islander population, no comparisons with previous surveys for this population are possible.

However, biomedical data was also collected for all Australians in the 2011-12 National Health Measures Survey (NHMS) and information about comparisons between the NHMS results and those of non-ABS surveys is available from the Comparisons with other Australian surveys section of the Biomedical Results for Chronic Diseases, 2011-12 publication.


1 Kidney Health Australia 2013, What is Kidney disease?, <http://www.kidney.org.au/kidneydisease/tabid/578/default.aspx>, Last accessed 08/09/2014.
2 Kidney Health Australia 2013, Chronic Kidney Disease (CKD) Management in General Practice. 2nd Edition 2012 <http://www.kidney.org.au/HealthProfessionals/CKDManagementinGeneralPractice/tabid/789/Default.aspx>, Last accessed 08/09/2014.
3 David W Johnson, Graham R D Jones, Timothy H Mathew, Marie J Ludlow, Stephen J Chadban, Tim Usherwood, Kevan Polkinghorne, Stephen Colagiuri, George Jerums, Richard MacIsaac and Helen Martin, Australasian Proteinuria Consensus Working Group 2012, Chronic kidney disease and measurement of albuminuria or proteinuria: a position statement, <https://www.mja.com.au/journal/2012/197/4/chronic-kidney-disease-and-measurement-albuminuria-or-proteinuria-position>, Last accessed 08/09/2014.

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