Study of Microalbuminuria as a Marker in Patients with Septicemia-A Prospective Study in a Tertiary Care Teaching Centre

Abstract

Background: Sepsis remains a major cause of ICU mortality worldwide. Early risk stratification is crucial for improving outcomes. We investigated urinary albumin-to-creatinine ratio (UACR) as a non-invasive biomarker of endothelial dysfunction in sepsis.

Methods: Prospective observational study of 89 ICU patients with sepsis admitted to a tertiary care center. Serial UACR measurements were performed at admission (spot), 24 hours, and 48 hours. Additional biomarkers (CRP, lactate) and clinical outcomes were recorded. Statistical analysis used Mann-Whitney U test.

Results: At baseline (spot UACR), values were comparable between survivors and non-survivors (51.11 vs 51.25 mg/g, p=1.0). By 24 hours, non-survivors showed higher UACR (128.66 vs 106.9 mg/g, p=0.0275). At 48 hours, UACR was significantly elevated in non-survivors (174.08 vs 100.35 mg/g, p<0.001), exceeding the discriminatory power of CRP and lactate. Serial UACR monitoring showed progressive divergence between survivors and non-survivors over time. Demographics showed 60.7% survival rate; older age groups (70-79 years) had highest mortality (67%). Gram-negative organisms predominated (65% of cultures).

Conclusions: UACR at 48 hours is a powerful, non-invasive prognostic marker in sepsis. Serial monitoring is superior to single baseline measurements. UACR reflects systemic endothelial dysfunction and serves as a practical alternative to conventional biomarkers, particularly in resource-limited settings.a