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Microalbuminuria: a marker of endothelial dysfunction in thermal injury

E Vlachou1, P Gosling, N S Moiemen

  • 1University Hospital Birmingham, UK. lilly@doctors.org.uk

Burns : Journal of the International Society for Burn Injuries
|August 4, 2006
PubMed
Abstract

Insights

Severe burns cause systemic endothelial dysfunction, indicated by microalbuminuria. This dysfunction can recur with wound manipulation and is worsened by inhalation injury, alcohol, or accelerants, not just burn size.

Area of Science:

  • Burn injury research
  • Vascular biology
  • Clinical diagnostics

Background:

  • Severe burns trigger systemic endothelial dysfunction (SED) and capillary leak.
  • Microalbuminuria, detected via sensitive immunoassay, serves as a biomarker for SED.
  • This study investigated microalbuminuria's relationship with burn severity and contributing factors.

Purpose of the Study:

  • To compare the extent and duration of microalbuminuria following severe burns.
  • To assess the correlation between microalbuminuria and burn surface area.
  • To identify aggravating factors influencing microalbuminuria.

Main Methods:

  • Collected serial urine samples from 43 adult burn patients (mean TBSA 32%) over 36 hours post-injury.
  • Monitored urine samples during 44 wound manipulation episodes.
  • Measured urinary albumin as albumin/creatinine ratio (ACR), with normal <2.3 mg/mmol.

Main Results:

  • Median ACR peaked at 2 hours post-burn (12.3 mg/mmol) and normalized within 6 hours.
  • Full-thickness burns were associated with elevated ACR between 3-7 hours.
  • Inhalation injury, alcohol intoxication, or accelerant use significantly increased ACR for up to 8 hours.
  • ACR elevations occurred within 30 minutes of escharotomy or wound scrubbing.

Conclusions:

  • Severe burns induce variable SED that can recur with wound manipulation.
  • Inhalation injury, alcohol intoxication, and accelerants are more strongly associated with SED than TBSA.
  • Microalbuminuria is a valuable tool for monitoring microvascular integrity in early post-burn recovery.

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