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Yoğun Bakım Hastalarında Mikroalbuminürinin Prognostik Değeri

Prognostic Value of Microalbuminuria in Critically Ill Patients

Journal Name:

  • Uludağ Üniversitesi Tıp Fakültesi Dergisi

Publication Year:

  • 2008

Key Words:

Keywords (Original Language):

Author NameUniversity of Author
Abstract (2. Language): 
We were aimed to the prognostic value of microalbuminuria which indicates the increase of glomerular permeability due to inflammation in the mortality of critically ill patients. Urine samples were collected from 52 patients who were admitted to the intensive care unit (ICU) and examined for microalbuminuria/creatininuria (MACR) (mg/g) in 12 h. Exclution criteria were history of diabetes mellitus, renal failure. Patients were randomly selected into two groups as medical (Group M) and travma (Group T). Diagnosis at admission age, gender, comorbid disease, hourly urinary output, ICU stay length and mechanical ventilation period for each patient were recorded. Acute Physiology and Chronic Health Evaluation Score (APACHE II), Simplified Acute Physiology Score (SAPS II), and Multipl Organ Dysfunction Score (MODS) were calculated. The MACR values were compared with the APACHE II, SAPS II and MODS scores between two groups. There were no statistically significant correlation between MACR values and APACHE II, SAPS II, MODS, ICU stay length and mechanical ventilation period in group M. There were statistically significant correlation between MACR values and APACHE II, SAPS II and MODS scores in group T (p<0.05, p<0.05, p<0.05). In all patients there were statistically significant correlation between MACR values and SAPS II score (p<0.05). There were a statistically significant correlation between MACR values and APACHE II, SAPS II, MODS and ICU stay length survivors and nonsurvivors (p<0.05, p<0.01, p<0.01, p<0.05, p<0.05). For survivors, MACR decreased while it increased in nonsurvivors. The mortality rate was significantly higher in patients who have comorbid diseases history (p<0.05). MACR values that increased after acute inflammation may be considered as a marker of poor prognosis. If MACR measurements become more feasible, the requirement for ICU may be decided earlier.
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Abstract (Original Language): 
Çalışmamızda, inflamasyona bağlı glomerüler geçirgenlik artışını yansıtan mikroalbüminürinin, yoğun bakım hastalarında mortalite yönünden prognostik değerinin araştırılması amaçlandı. Yoğun bakıma kabul edilen 52 olgudan, 12 saat içinde iki idrar örneği alındı ve mikroalbüminüri/kreatininüri (MACR) oranı (mg/g) hesaplandı. Diyabetes mellitus ve renal yetmezliği olanlar çalışma dışı bırakıldı. Olgular medikal (Grup M) ve travma (Grup T) grubu olarak ikiye ayrıldı. Tanı, yaş, cins, yandaş hastalık, saatlik idrar miktarları, yoğun bakım ve mekanik ventilasyon süreleriyle yoğun bakımdan çıkış nedenleri kaydedildi. Akut fizyolojik ve kronik sağlık değerlendirme skoru (APACHE II), basitleştirilmiş akut fizyolojik skor (SAPS II) ve çoklu organ disfonksiyon skoru (MODS) hesaplandı. Her iki grupta MACR değerleriyle skorlar arasında ilişki olup olmadığı araştırıldı. Grup M’de MACR ile APACHE II, SAPS II, MODS, yoğun bakım ve mekanik ventilasyon süreleri arasında korelasyon bulunmadı. Grup T’de MACR ile APACHE II, SAPS II ve MODS arasında (p<0.05, p<0.05, p<0.05), tüm hastalarda MACR ile SAPS II arasında pozitif korelasyon bulundu (p<0.05). Yaşayan ve ölen hastalar karşılaştırıldığında, yaşayanlarda MACR değerleri ve skorlar düşük, yoğun bakımda kalış süresi uzundu (p<0.05, p<0.01, p<0.01, p<0.05, p<0.05). Yandaş hastalığı olanlarda ölüm oranı yüksekti (p<0.05). Akut inflamasyon sonrası yükselen MACR, prognozun kötüleştiğinin göstergesidir. MACR ölçümleri pratik hale getirilerek yoğun bakım gereksinimi olan olguların daha erken belirlenmesinde kullanılabilir.
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  • 3
107-114
  • Turkish

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