title: Microalbuminuria in acute burn injury.
abstract: Microalbuminuria is a known finding in inflammatory states. We hypothesized that urinary albumin/creatinine ratio (ACR) would correlate with injury severity and resuscitation demands after acute burns. This pilot study evaluated 30 adults admitted within 12 hours of injury with burns > or =10% total body surface area burn injury (TBSA). The urinary ACR was calculated for each patient at 7 to 12 hours, 19 to 24 hours, and 43 to 48 hours following burn injury. Microalbuminuria was defined as a urinary ACR > or =20 mg/g. Study patients (23 males, 7 females) had a mean age of 42.9 + 14.0 years and a median TBSA burn injury of 18.8%. Inhalation injury was present in 10 of the study patients, and all patients with inhalation injury had microalbuminuria at the time of admission. One study patient died. Median time from burn injury to resuscitation was 30 hours, and the median fluid requirement was 4.2 ml/kg/%TBSA. Microalbuminuria was not uniformly present in burn-injured patients during the first 48 hours after injury. ACR values early in the hospital course correlated with higher lactate concentrations early after burn injury. However, ACR correlated with neither injury severity nor resuscitation demands after burn injury during any studied time range. Microalbuminuria does not have apparent clinical utility in burn-injured patients, and other markers of injury severity and resuscitation demands should be sought.
authors.affiliation: Burn Center, University of Utah, Salt Lake City, Utah 84132, USA.
authors.forename: Amalia
authors.initials: A
authors.lastname: Cochran
authors.forename: Lydia
authors.initials: L
authors.lastname: Dong
authors.forename: Linda S
authors.initials: LS
authors.lastname: Edelman
authors.forename: William L
authors.initials: WL
authors.lastname: Roberts
authors.forename: James
authors.initials: J
authors.lastname: Ballard
authors.forename: Alicia
authors.initials: A
authors.lastname: Privette
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Morris
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Saffle
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000418:Albumins; D000419:Albuminuria / Q000209:etiology* / Q000503:physiopathology; D002056:Burns / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D003404:Creatinine; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D012151:Resuscitation; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D000418:Albumins; D003404:Creatinine