Serial microalbuminuria analysis in sepsis patients helps identify those requiring early treatment

Jaipur, Rajasthan: A new study published in the Journal of the Association of Physicians of India suggests that serial bedside urine albumin-creatinine analysis may aid in the early identification of individuals with sepsis who require early targeted treatment.

Despite breakthroughs in medical therapies, sepsis remains a significant healthcare risk in India and throughout the world. Because of the frequent delays in diagnosis, tailored medicines are less successful. There is no conventional strategy for detecting sepsis early in severely unwell individuals.

As a result, CL Nawal and colleagues undertook this study with the goal of determining the difference in microalbuminuria levels between sepsis and non-sepsis individuals. The decrease in levels over the first 24 hours was also compared to two sepsis scores, APACHE II (Acute Physiology and Chronic Health Evaluation) and SOFA (Sequential Organ Failure Assessment), for morbidity and death prediction.

In this study, 150 patients were included, with 75 patients from each sepsis and non-sepsis group admitted to the Medical Intensive Care Unit (ICU). Microalbuminuria levels were measured upon admission and 24 hours later.

The key findings of this study were as follows:

1. Microalbuminuria levels were substantially higher in sepsis patients than in non-sepsis patients.

2. In comparison to APACHE II and SOFA scores, microalbuminuria had the greatest sensitivity of 90% and specificity of 98% for distinguishing between sepsis and non-sepsis.

3. In terms of mortality, group A had 24 deaths out of 75 patients, whereas group B had only 15 deaths out of 75 patients.

In conclusion, this study suggests many possible applications for microalbuminuria monitoring in the severely unwell. Serial bedside urine albumin-creatinine measurement may aid in the early identification of individuals with sepsis who require early targeted treatment. The 24-hour ACR evaluation predicts ICU survival and has the ability to evaluate the success of therapeutic measures such as fluid resuscitation, suitable antibiotics, vasopressors, and endothelium-affecting inotropes.

Reference:

Nawal CL, Barasara S, Chejara RS, Meena PD, Singh A, Meena VK. Microalbuminuria: As an Indicator of Sepsis and to Predict Mortality in Patients Admitted to Intensive Care Unit. J Assoc Physicians India. 2022 Mar;70(3):11-12. PMID: 35438283.