Noortje Godijn
Purpose: To determine the course of albuminuria in critically sick patients and its relationship to the APACHE II score, SOFA score, infection markers, and outcome. Methods: We Measured Albumin Creatinine Ratio (MACR) for all sequentially hospitalized ICU patients in a prospective cohort study. Gender, age, admission diagnosis, type of admission (medical, surgical), length of stay, and days of follow up were all recorded as baseline data. Medical and surgical subgroups, as well as diabetes and non-diabetes, were created from the cohort. When possible, patients were followed for ten days. Results: A total of 150 individuals were included in the study, with a median age of 68.6 years. The patients' APACHE II scores were 20.5 and their SOFA scores averaged 5.0. In the first five days, the ACR rises in all patients. On day 1, the median ACR was 29.2 mg/mmol, and on day 5, the median ACR was 45.5 mg/mmol. The ACR reduced after day five for all subgroups except diabetes individuals. A significant association was found between mean ACR per patient and age (r=0.19), APACHE II (r=0.48), mean SOFA score (r=0.41), and serum creatinine (r=0.25) using Spearman rho correlation. A correlation between ACR and CRP was discovered only in surgical patients. Serum creatinine is linked to ACR and acts as a confounder in the relationship between ACR and the SOFA score. There was no significant difference in mean micro albuminuria between survivors and non-survivors on the first day. Conclusion: All critically ill patients ACR rises in the first five days. Except for diabetic and medical patients, there was a link between ACR and physiologic severity scores of disease.
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