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Highly Sensitive Measurement of Glomerular Permeability in Mice with Fluorescein Isothiocyanate-polysucrose 70
09:16

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Published on: August 9, 2019

Microalbuminuria: A novel biomarker of sepsis

Surupa Basu1, Mahuya Bhattacharya, Tapan K Chatterjee

  • 1Department of Laboratory Medicine, Advanced Medicare Research Institute Hospitals, Kolkata, India.

Indian Journal of Critical Care Medicine : Peer-Reviewed, Official Publication of Indian Society of Critical Care Medicine
|July 8, 2010
PubMed
Abstract

Insights

Microalbuminuria, a marker of endothelial dysfunction in sepsis, can help identify patients with sepsis and predict mortality. Elevated levels at 24 hours strongly indicate a higher risk of ICU death.

Area of Science:

  • Critical Care Medicine
  • Nephrology
  • Infectious Diseases

Background:

  • Sepsis-induced endothelial dysfunction increases capillary permeability, leading to microalbuminuria.
  • Microalbuminuria levels correlate with sepsis severity and can predict patient outcomes.

Purpose of the Study:

  • To determine if microalbuminuria can differentiate sepsis patients from non-sepsis patients.
  • To assess the predictive value of microalbuminuria for mortality in critically ill patients.

Main Methods:

  • Prospective study in a tertiary care hospital ICU.
  • Measured urinary albumin-creatinine ratio (ACR) on admission (ACR1) and at 24 hours (ACR2) in 94 adult patients.
  • Used ROC curve analysis to evaluate diagnostic and predictive performance.

Main Results:

  • Sepsis patients (n=30) had significantly higher ACR1 than non-sepsis patients (n=64) (P=0.0016).
  • ACR1 at 124 mg/g differentiated sepsis with 80% sensitivity and 64.1% specificity.
  • Higher ACR2 in non-survivors (n=13) predicted ICU mortality (99.6 mg/g cut-off, 85% sensitivity, 68% specificity).

Conclusions:

  • Low microalbuminuria on ICU admission suggests absence of sepsis.
  • Elevated microalbuminuria at 24 hours is a strong predictor of ICU survival.
  • Microalbuminuria offers a prognostic tool comparable to APACHE II scores.
Keywords:
Capillary permeabilitycritically illintensive care unitsmicroalbuminuriamortalitysepsis

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