Microalbuminuria: a biomarker of sepsis and efficacy of treatment in patients admitted to a medical intensive care unit of a tertiary referral center.
BACKGROUND
The outcome of sepsis is significantly affected by early institution of goal-directed therapies and hence, the search for an early marker of sepsis continues.


OBJECTIVE
To observe microalbuminuria levels between patients with sepsis and those without sepsis s admitted to the medical intensive care unit (MICU) of a tertiary referral centre (primary) as also to assess the change in microalbuminuria levels in the first 24 hours as a predictor of mortality and morbidity relative to the APACHE II and SOFA scores.


METHODS
This was a prospective observational study where 125 patients with sepsis and 38 without were assessed. Trend of microalbuminuria was assessed from the change of ACR value within 6 hours of admission (ACR1) to the ACR value at 24 hours (ACR2) in both groups of patients.


CONCLUSIONS
Significantly higher levels of microalbuminuria were found among patients with sepsis as compared to those without sepsis. The levels decreased in survivors with sepsis after 24 hours, whereas they continued to remain almost at the same levels among those without sepsis. The change in microalbuminuria levels over 24 hours can be used to measure the effectiveness of therapy. Persistence of high levels or increasing trend of microalbuminuria levels over 24 hours was found to be a predictor of a poor outcome. A high level of microalbuminuria at 24 hours and increasing trend of microalbuminuria also predicted mortality better than APACHE II and SOFA scores.
Department of Medicine, Topiwala National Medical College and B.Y.L. Nair Ch. Hospital, Mumbai Central, Mumbai, Maharashtra, India.
R R
RR
Bhadade
R
R
deSouza
M J
MJ
Harde
B
B
Sridhar
D018806:APACHE; D000368:Aged; D000419:Albuminuria / Q000175:diagnosis* / Q000453:epidemiology / Q000652:urine; D015415:Biomarkers; D016022:Case-Control Studies; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007194:India / Q000453:epidemiology; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D018570:Risk Assessment; D018805:Sepsis / Q000097:blood / Q000175:diagnosis*; D012720:Severity of Illness Index; D062606:Tertiary Care Centers; D013997:Time Factors
D015415:Biomarkers