Email this article Relation of proteinuria with severity assessment scores among intensive care unit-admitted patients at a tertiary care hospital in central India
Abstract
Proteinuria was an indicator of both glomerular and renal endothelial injury in chronic disease, acute illness or post-surgery. Current study conducted with the aim of monitoring of proteinuria levels and predicting of mortality and morbidity of medical intensive care unit (MICU) admitted patients. Current non-randomized hospital based cross-sectional study conducted in 96 MICU admitted patients. A series of urine samples for measuring protein was taken for quantitative and qualitative measurement on day 1, day 3 and day 5. Severity of MICU admitted patients had been calculated by using APACHE II and Sequential Organ Failure Assessment (SOFA) score. Percent of patients with grade +3 proteinuria were increased from day 1 to 5. Mean APACHE II scores were significantly decreases from day 1 to 5, while mean SOFA scores was non-significantly increases from day 1 to 5. Moreover, mean values of APACHE-II (7.73 %) and SOFA (6.5 %) scores were significantly increasing with rise in levels of proteinuria on day 1, day 3 and day 5 of admission among survivors (P <0.05). However, there was non-significant relationship of APACHE-II and SOFA scores with outcome by comparing values of day 1 and day 3, but proteinuria had significant relationship with outcome on day 3. Proteinuria, APACHE-II and SOFA scores at admission can be used for quantifying degree of dysfunction or failure and triage of patients into risk categories for further management. Highest APACHE-II and SOFA scores can identify critical point at which patient exhibit highest degree of organ dysfunction at MICU stay.
Keywords
Full Text:
Full-text PDFReferences
Ärnlöv J, Evans JC, Meigs JB, Wang TJ, Fox CS, Levy D, et al. Low-Grade Albuminuria and Incidence of Cardiovascular Disease Events in Nonhypertensive and Nondiabetic Individuals. Circulation. 2005; 112(7):969-75.
Gosling P, Brudney S, McGrath L, Riseboro S, Manji M. Mortality prediction at admission to intensive care: A comparison of microalbuminuria with acute physiology scores after 24 hours. Crit Care Med. 2003; 31(1):98-103.
Hu JY, Meng XC, Han J, Xiang F, Fang YD, Wu J, et al. Relation between proteinuria and acute kidney injury in patients with severe burns. Critical Care. 2012; 16(5):R172-R72.
Haider R. Obesity and Diabetes. Endocr Disord. 2023; 7(5):01-12.
Sviridov D, Owen WE, Roberts WL, Edelman LS, Drake SK, Hortin GL. Proteinuria without albuminuria: urinary protein excretion by a subset of patients with burn injuries. Clinica chimica acta; international journal of clinical chemistry. 2009; 403(1-2):42-46.
Hilton R. Acute renal failure. BMJ (Clinical research ed). 2006; 333(7572):786-90.
Curiel-Balsera E, Prieto-Palomino MA, Fernández-Jiménez S, Fernández-Ortega JF, Mora-Ordóñez J, Delgado-Amaya M. Epidemiología, manejo inicial y análisis de morbimortalidad del gran quemado. Med Intensiva. 2006; 30(8):363-69.
Chertow GM, Burdick E, Honour M, Bonventre JV, Bates DW. Acute kidney injury, mortality, length of stay, and costs in hospitalized patients. J Am Soc Nephrol. 2005; 16(11):3365-70.
Coca SG, Yusuf B, Shlipak MG, Garg AX, Parikh CR. Long-term risk of mortality and other adverse outcomes after acute kidney injury: a systematic review and meta-analysis. Am J Kidney Dis. 2009; 53(6):961-73.
Lopes JA, Jorge S, Neves FC, Caneira M, da Costa AG, Ferreira AC, et al. An assessment of the rifle criteria for acute renal failure in severely burned patients. Nephrol Dial Transplant. 2006; 22(1):285-85.
Case J, Khan S, Khalid R, Khan A. Epidemiology of acute kidney injury in the intensive care unit. Critical care research and practice. 2013; 2013:479730-30.
Waikar SS, Betensky RA, Bonventre JV. Creatinine as the gold standard for kidney injury biomarker studies? Nephrol Dial Transplant. 2009; 24(11):3263-65.
Jefferson JA, Shankland SJ, Pichler RH. Proteinuria in diabetic kidney disease: A mechanistic viewpoint. Kidney Int. 2008; 74(1):22-36.
Jain A, Palta S, Saroa R, Palta A, Sama S, Gombar S. Sequential organ failure assessment scoring and prediction of patient's outcome in Intensive Care Unit of a tertiary care hospital. Journal of anaesthesiology, clinical pharmacology. 2016; 32(3):364-68.
Gupta A, K K, Virmani SK, Arora M. Thyroid dysfunction in patients of chronic kidney disease. Int J Adv Med. 2017; 4(5):1333.
Wagner DP, Draper EA. Acute physiology and chronic health evaluation (APACHE II) and Medicare reimbursement. Health Care Financ Rev. 1984; Suppl(Suppl):91-105.
Haq A, Patil S, Parcells AL, Chamberlain RS. The Simplified Acute Physiology Score III Is Superior to the Simplified Acute Physiology Score II and Acute Physiology and Chronic Health Evaluation II in Predicting Surgical and ICU Mortality in the "Oldest Old". Current gerontology and geriatrics research. 2014; 2014:934852-52.
Vasilevskis EE, Kuzniewicz MW, Cason BA, Lane RK, Dean ML, Clay T, et al. Mortality probability model III and simplified acute physiology score II: assessing their value in predicting length of stay and comparison to APACHE IV. Chest. 2009; 136(1):89-101.
Kaufmann I, Briegel J. Therapeutic Intervention Scoring System (TISS) - a method for calculating costs in the intensive care unit (ICU) and intermediate care unit (IMCU). Critical Care. 2000; 4(Suppl 1):P243.
Heldwein MB, Badreldin AMA, Doerr F, Lehmann T, Bayer O, Doenst T, et al. Logistic Organ Dysfunction Score (LODS): a reliable postoperative risk management score also in cardiac surgical patients? Journal of cardiothoracic surgery. 2011; 6:110-10.
Peres Bota D, Melot C, Lopes Ferreira F, Nguyen Ba V, Vincent J-L. The Multiple Organ Dysfunction Score (MODS) versus the Sequential Organ Failure Assessment (SOFA) score in outcome prediction. Intensive Care Med. 2002; 28(11):1619-24.
Rapsang AG, Shyam DC. Scoring systems in the intensive care unit: A compendium. Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine. 2014; 18(4):220-28.
Zimmerman JE, Kramer AA, McNair DS, Malila FM, Shaffer VL. Intensive care unit length of stay: Benchmarking based on Acute Physiology and Chronic Health Evaluation (APACHE) IV*. Crit Care Med. 2006; 34(10):2517-29.
Higgins TL, Teres D, Copes WS, Nathanson BH, Stark M, Kramer AA. Assessing contemporary intensive care unit outcome: An updated Mortality Probability Admission Model (MPM0-III)*. Critical care medicine. 2007; 35(3):827-35.
Moon BH, Park SK, Jang DK, Jang KS, Kim JT, Han YM. Use of APACHE II and SAPS II to predict mortality for hemorrhagic and ischemic stroke patients. J Clin Neurosci. 2015; 22(1):111-15.
Vincent J-L, de Mendonca A, Cantraine F, Moreno R, Takala J, Suter PM, et al. Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units. Critical care medicine. 1998; 26(11):1793-800.
Jones AE, Trzeciak S, Kline JA. The Sequential Organ Failure Assessment score for predicting outcome in patients with severe sepsis and evidence of hypoperfusion at the time of emergency department presentation. Crit Care Med 2009; 37(5):1649-54.
Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II. Critical Care Medicine. 1985; 13(10):818-29.
Sinuff T, Adhikari NKJ, Cook DJ, Schünemann HJ, Griffith LE, Rocker G, et al. Mortality predictions in the intensive care unit: Comparing physicians with scoring systems*. Crit Care Med 2006; 34(3):878-85.
Zimmerman JE, Kramer AA. Outcome prediction in critical care: the Acute Physiology and Chronic Health Evaluation models. Curr Opin Crit Care. 2008; 14(5):491-97.
Chen J-J, Yang C-H, Tian Y-C, Yang C-W, Chen Y-C, Chang C-H, et al. Proteinuria Enhances Prediction Ability of Sequential Organ Failure Assessment Score and Associated with Mortality in Coronary Care Units. Acta Nephrol. 2017; 1(31):188-96.
Godijn N. Albuminuria in Critically Ill Patients: A Prospective Cohort Study. Int J Crit Care Emerg Med. 2015; 1(1).
Ashok A, Mushtaque P. Clinical Study using Urinary Albumin / Creatinine Ratio as an Early Predictor of Prognosis in Critically III Septic Patients. Int J Sci Study. 2019; 7:9-13.
Ho KM. Combining Sequential Organ Failure Assessment (SOFA) Score with Acute Physiology and Chronic Health Evaluation (APACHE) II Score to Predict Hospital Mortality of Critically Ill Patients. Anaesth Intensive Care. 2007; 35(4):515-21.
Bhadade RR, deSouza R, Harde MJ, Sridhar B. Microalbuminuria: a biomarker of sepsis and efficacy of treatment in patients admitted to a medical intensive care unit of a tertiary referral center. J Postgrad Med. 2014; 60(2):145-50.
Varghese YE, Kalaiselvan MS, Renuka MK, Arunkumar AS. Comparison of acute physiology and chronic health evaluation II (APACHE II) and acute physiology and chronic health evaluation IV (APACHE IV) severity of illness scoring systems, in a multidisciplinary ICU. Journal of anaesthesiology, clinical pharmacology. 2017; 33(2):248-53.
Polita JR, Gomez J, Friedman G, Ribeiro SP. Comparison of APACHE II and three abbreviated APACHE II scores for predicting outcome among emergency trauma patients. Rev Assoc Med Bras. 2014; 60(4):381-86.
Ferreira FL. Serial Evaluation of the SOFA Score to Predict Outcome in Critically Ill Patients. JAMA. 2001; 286(14):1754.
Baradari AG, Firouzian A, Davanlou A, Aarabi M, Daneshiyan M, Kiakolaye YT. Comparison of patients' admission, mean and highest SOFA scores in prediction of ICU mortality: a prospective observational study. Materia socio-medica. 2016; 28(5):343-47.
Kumar M, S CC. SOFA scoring system in assessing prognosis of critically ill surgical and trauma patients: a prospective study. Int Surg J. 2018; 5(7):2528.
Gupta V, Karnik ND, Agrawal D. SOFA Score and Critically Ill Elderly Patients. J Assoc Physicians India. 2017; 65(7):47-50.
Vishnuram P NK, Karuppusamy N, Manojkumar V, Bakiaraj K. Evaluation of critically ill patients in intensive care unit in tertiary care hospital in south India with respect to SOFA scoring system – for predicting the prognosis – A prospective cohort study. IOSR J Dent Med Sci. 2016; 15(5):48-63.
Refbacks
- There are currently no refbacks.
Copyright (c) 2024 © The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.