Prognostic Value of Urinary Albumin Creatinine Ratio in Septic Patients and Its Role in Early Detection of Acute Kidney Injury

Abstract

epsis remains a major global healthcare concern, owing to high morbidity and mortality, despite the advances in medical therapeutics. Targeted therapies probably lose their efficacy due to late administration. Early administration of intensive therapy to critically ill patients has shown promise in improving mortality. An early event is the loss of barrier integrity leading to systemic capillary leak which is manifested as increased excretion of albumin in the urine. Microalbuminuria, defined as 30–300 mg/day of albumin excretion in the urine is a common finding in critically ill patients, where it has shown promise not only as a predictor of organ failure and vasopressor requirement but of mortality, faring better than SOFA and APACHE II score. This study was conducted in critical care department to evaluate the degree of microalbuminuria (ACR) in sepsis patients and whether it could predict mortality in critically ill sepsis patients and early detection of acute kidney injury, also to evaluate the relationship between microalbuminuria and SOFA &APACHE II score. Patients presenting with features of sepsis and suspected infection were included in the study and after exclusion, a total of 40 patients were included in the study. Urine sample for ACR (Albumin and Creatinine Ratio) was done at ICU admission (ACR1) and at 24 hours (ACR2) of admission and APACHI II &SOFA calculated.