A patient has a urine albumin-to-creatinine ratio (UACR) of 350 mg/g. Into which albuminuria category does this fall, and what is the associated risk?

• A. Normal to mildly increased albuminuria; low risk of CKD progression
• B. Moderately increased albuminuria; increased risk of CKD progression and cardiovascular disease
• C. Severely increased albuminuria; high risk of progression but lower cardiovascular risk
• D. No albuminuria; no added risk to CKD progression

Answer: (B)

Albuminuria levels are used to gauge risk for CKD progression and cardiovascular disease. The typical thresholds are: normal to mildly increased (<30 mg/g), moderately increased (30–300 mg/g), and severely increased (>300 mg/g). A urine albumin-to-creatinine ratio of 350 mg/g sits in the severely increased range, which carries a high risk of CKD progression and cardiovascular events. The option that mentions increased risk aligns with the general concept that any elevation above normal raises risk, but the precise, highest-risk category for this level is severe. In clinical practice, this level would prompt intensified risk-factor management and closer follow-up.