Secondary Logo

Abstract O-35: PROGNOSTIC VALUE OF MICROALBUMINURIA IN CHILDREN WITH SEPSIS

Sachdev, A.1; Raheja, K.1; Gupta, D.1; Gupta, N.1

Pediatric Critical Care Medicine: June 2018 - Volume 19 - Issue 6S - p 16
doi: 10.1097/01.pcc.0000537377.77085.cb
Oral Abstracts
Free

1Sir Ganga Ram Hospital, Division of Pediatric Emergency- Critical Care & Pulmonology, New Delhi, India

Back to Top | Article Outline

Aims & Objectives:

To study the relationship between microalbuminuria (ACR) with organ system dysfunction and mortality in septic children.

Back to Top | Article Outline

Methods

This prospective observational study was conducted at tertiary level PICU. Children between age 1 month and 16 years admitted with sepsis, and with anticipated stay of >24 hrs were enrolled. Patients with anuria, macroscopic hematuria, diabetes mellitus or pre-existing chronic kidney disease were excluded. Besides clinical data, PRISM 12, 24, PELOD score and relevant laboratory reports, ACR was obtained at admission (ACR 0), 12 (ACR 12) and 24 hrs (ACR 24). ACR >120 mcg/mg of creatinine was considered significant.

Back to Top | Article Outline

Results

138 patients were enrolled fulfilling eligibility criteria of sepsis (n-56), severe sepsis (n-31), septic shock (n-22) and sepsis with MODS (n-29). ACR 0, 12 and 24 showed significantly higher trends in different sepsis groups (P <0.01). The ACR 12 and 24 correlated with PRISM 12 (r- 0.57, P<0.01 and 24 (r- 0.66, P<0.01) respectively and also with PELODS 12 and 24 (P<0.01). The ACR 12 and 24 correlated significantly with blood pH and lactate levels at 12 and 24 hrs admission but no correlation between ACR 0 and admission lactate (figure 1, 2). ACR 12 and 24 predicted mortality with OR 1.002 (95%CI 1.000–1.003, P-0.01) and 1.003 (95%CI 1.001–1.005, P-0.004) (Table 1). There were 29 deaths with significantly higher ACR 12 and 24. (174 ± 173.6 vs 315 ± 364.6, P-0.008; 170.3 ± 175.4 vs 313.7 ± 299.7, P-0.005).

Table

Table

Figure

Figure

Figure

Figure

Back to Top | Article Outline

Conclusions

Rising microalbuminuria trends may be used to predict organ dysfunction and mortality.

©2018The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies