Study of Microalbuminuria in Patients with Sepsis

Sepsis is very common, it adversely affect all organs of body. Early diagnosis of sepsis is very critical so that proper therapy can be given to patient. Microalbuminuria is one of early marker of sepsis.

To study prognostic significance of microalbuminuria is sepsis.

This study was conducted on 150 patients, out of 150, 100 were cases and 50 were control. All patients were >14 yrs. Diagnosis of sepsis was based on patients who were having SIRS of suspected proven infective etiology. Each patient was subjected to full scale clinical examination, all necessary investigations such as: CBC, RFT,LFT, Blood Culture,albumin creatinine ratio(ACR) at admission and at 4hrs, Chest X-Ray, USG Abdomen, RBS etc. SAPS II score was calculated for all patients.

Microalbuminuria was present in all patients who were having sepsis whereas it was absent in 8 patients who were not having sepsis. Among 150 patients 26 died, all 26(100%) were having sepsis. 126 patients were survivors,among survivors 74 patients(59.35) were having sepsis. Mean ACR at admission of nonsurvivors was 163.50, whereas it was for survivors 94.06. Mean ACR at 24 hrs of nonsurvivors was 286.08, whereas it was for survivors 49.10. On ROC curve analysis for mortality prediction area under curve was maximum for ACR at admission (0.714) then 0.694 for SAPS 2 score, 0.667 for ACR at 24hrs, for delta ACR 0.659.

Sepsis patients had significantly high level of microalbuminuria than who were not having sepsis. Higher microalbuminuria level at admission was indicator of poor prognosis as most of patients who died were having high level of microalbuminuria at admission. Higher level of microalbuminuria at admission predicted mortality better than SAPS 2 score,microalbuminuria at 24 hrs and change in level of microalbuminuria over 24 hrs.