Microalbuminuria as an early index of impairment of glomerular permeability in postoperative septic patients

Objective:To evaluate whether microalbuminuria increases in post-operative patients developing sepsis, and whether it is correlated to the sepsis seve rity score (SOFA) and the PaO2/FIO2 ratio. Design: Prospective study. Setting: University intensive care unit. Patient population: Fifty-five postoperative ASA II-III patients admitted t o the ICU after major abdominal or vascular surgery. Interventions: None. Measurements and results: Urine collection and measurement of microalbuminu ria and urinary creatinine on admission and again as soon as sepsis develop ed or at the end of the study (72 h after admission). Results are expressed as the micro-albuminuria/creatinine ratio (MACR). The MACR significantly i ncreased as soon as sepsis (defined according to the ACPP/SCCM Consensus Co nference) appeared. The MACR positively correlated to the SOFA score, but h ad no relation to the PaO2/FIO2 ratio. Patients not developing sepsis did n ot show any increase in the MACR during the study period. Conclusions: Post-operative patients developing sepsis, unlike those with a n uncomplicated postoperative evolution, showed an increase in glomerular p ermeability which was revealed by MACR. The increase in the MACR was positi vely correlated to the increase in SOFA score, while it had no relation to the PaO2/FIO2 ratio.