A STUDY OF MICROALBUMINURIA IN SEPSIS AND ITS PROGNOSTIC SIGNIFICANCE IN CRITICALLY ILL PATIENTS

Dr. Mamatha T. R, Dr. Jeetendra kumar J. M, Dr. Satyanarayana. N

Abstract


a) Background : Microalbuminuria occurs  due to changes in glomerular permeability within few hours of inflammation in sepsis.  It reflects generalised endothelial damage throughout the vasculature.  So,  microalbumiuria  serve as marker of sepsis. The measurement of microalbuminuria at the time of admission and after 24 hour of admission can be taken as prognostic indicator of mortality in critically ill patients.

b) Materials and Methods : This is a prospective study of 100 patients admitted to emergency ward and ICU. The microalbumiuria was assessed to evaluate as marker of sepsis and to predict ICU mortality. Albumin creatinine ratio 1 (ACR 1) is considered as marker in sepsis and albumin creatinine ratio (ACR 2) is considered as the prediction of ICU mortality.

c) Results - In our study, Microalbuminuria occurred in 68.3% of the patient. Mortality rate was 70.38%. Median ACR1 was 140.05 among survivors and ACR 1 among non-survivors was 262.77, p value was <0.001 which was statistically significant. Median ACR2 among survivors was 220.62 and median ACR2 among non survivors was 412.36, p value was < 0.001 which was statistically significant, indicating ACR2 can be taken as prognostic marker in ICU mortality.

d) Conclusion - Microalbuminuria is a common in critically ill patients and reliable marker of sepsis. At 24hours of admission, ACR 2 indicates its prognostic significance among survivors and non survivors in critically ill patients.  


Keywords


Sepsis, Microalbumiuria, Albumin-Creatnine ratio.

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