I understand that an elevated randome urine microalbumin/cratinine ratio of 129 may be a sign of kidney disease for a type 2 diabetic, but how bad is?

Need more info: All laboratory results need to be interpreted in the clinical context and the doctor who ordered the tests is usually in the best position to do that. Having said that, it does put you at risk of kidney disease, nerve and eye damage and other microvacsular lesions. How bad depends on your creatinine, blood pressure and A1c levels.