A study of micro albuminuria in predicting the outcome of critically ill patients
Journal Title: MedPulse -International Medical Journal - Year 2015, Vol 2, Issue 9
Abstract
Introduction: Normally, as blood passes through healthy kidneys, it filters the waste products out and leaves in the things the body needs, like proteins in the blood is normally unable to pass through the glomerular capsule due to their large size. In normal urine, protein concentration is very low (less than 100mg/day) which cannot be detected by usual tests. These proteins are screened by tubular epithelial cells. However, it may be mentioned that there are a number of conditions such as diabetes mellitus, hypertensions, eclsmpsia, sever febrile illness, immune system disorders, abnormal swelling, malnutrition, or cancer and many other systematic infections which can result in protenuria. Aims and Objective: To Study Micro albuminuria In Predicting the Outcome of Critically Ill Patients Methodology: This was the prospective study in adult patients admitted to MEDICAL-ICU in Malla Reddy Institute of Medical Sciences, Hyderabad. will be recruited between December 2013 to July 2015. Result: A comparison between the survivors and non-survivors showed that the non-survivors had a significantly higher median APACHE II score and lower median ΔACR score. ACR2 was significantly higher in the patients who died on the ICU in comparison to those who survived. There was however no significant difference in the ACR1 value between the two groups. Change in urine albumin on intensive care unit admission (albumin-keratinize ratio (ACR1) and after 24 hours (ACR2) in survivors and non-survivors *p< 0.05 was considered significant, Wilcoxon test (paired samples). For all patients, ACR2 were significantly associated with increasing age. Both ACR1 and ACR2 were strongly associated with the duration of ICU stay. Duration of mechanical ventilation was correlated with ACR2. On admission serum keratinize was positively associated with ACR2 but failed to correlate with ACR1. ACR1, ACR2 and Δ ACR were not associated with estimated GFR (MDRD) on admission. ACR and ACR1 and ACR2 were strongly with APACHE II scores Conclusion: The study indicated that microalbumimnuria; a simple, non-invasive and inexpensive bedside tool could be effectively utilized to identify patients who are likely to survive in the ICU
Authors and Affiliations
Rajesh Enadle
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