Abstract P-296: INCREASED URINARY ALBUMIN-CREATININE RATIO IN SEPTIC CHILDREN ADMITTED TO PEDIATRIC INTENSIVE CARE UNIT

Abstract

Aims & Objectives: Elevated urinary albumin-creatinine ratio (ACR) is often found in critically ill patients and described as predictor of disease severity and mortality. Measurement of urinary ACR is not invasive, relatively low cost and commonly available. This study aims to investigate the level of urinary ACR and its association with disease severity and mortality in septic children admitted to pediatric ICU. Methods We examined urinary ACR of septic patients in pediatric ICU on day 1, 2, 3 and 7. Pediatric Logistic Organ Dysfunction (PELOD) score was recorded on day 1 and 3. Results Forty-nine septic subjects were recruited. Median value of urinary ACR was 489.0 (10.0–5446.0) mg/g. Urinary ACR > 300 mg/g was found in 33 (67.3%) subjects and 11 subjects had urinary ACR 30–300 mg/g on day 1. Non survivor group showed increased urinary ACR on day 3 while survivor group showed decreased urinary ACR (p = 0.010). Urinary ACR was increased in the group with PELOD score > 20 compared to < 20 group, but it was only statistically significant on day 1 [1102,0 (74–3988) mg/g vs 387 (10–5446) p = 0.012] and not statistically significant on day 3 [748,5 (210–9160) mg/g vs 293 (13–12819) p = 0.072 Conclusions Increased urinary ACR on day 3 of admission was associated with increased mortality. Increased urinary ACR was also associated with increased PELOD score, but it is only statistically significant on day 1.