Microalbuminuria as a Marker of sepsis-A Prospective Study in a Tertiary Care Hospital

Abstract

Background: There are various ICU scoring systems like APACHE and SAPS II to predict mortality which are done at 24 hours of admission during which precious time is lost in administering therapy. In various studies microalbuminuria has shown promise not only as a predictor of organ failure and vasopressor requirement but also of mortality. Aim: To evaluate the relation between microalbuminuria (urine micro albumin creatinine ratio) and SAPS II score in patients with sepsis and whether it could predict mortality in critically ill patients and the risk of developing multiorgan failure. Methods: In was a prospective, non-interventional study conducted on 64 patients admitted to ICU. Spot urine samples were collected at 6 and 24 hours of admission and were tested for urine microalbumin by immunoturbidometric method and for urine creatinine by Jaffe method and urine microalbumin: creatinine (Urine ACR) ratio was calculated. The urine ACR was co-related with SAPS II score and mortality of the patients. Results: SAPS II score ranged from 13 to 87. Median SAPS II score among survivors were 42.0 and among non survivors were 63.5. Non survivors had a higher SAPS II score compared to survivors (P value=0.0001).Urine ACR 1(urine micro albumin creatinine ratio at 6 hour) was 66.4 ?g/mg among survivors and 166.5 ?g/mg among non survivors and ACR 2 (urine micro albumin creatinine ratio at 24 hour) was 34.6 among survivors and 151.4 among non survivors (p value = 0.0001). Urine ACR 1 and Urine ACR 2 were correlated with SAPS II score and found statistically significance. Conclusion: The degree of microalbuminuria was more among patients with organ dysfunction than among patients with no organ dysfunction. Significant microalbuminuria is also predictive of organ dysfunction. Key words: Microalbuminuria, Sepsis, SAPS II score