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Volume 8 Pediatrics & Therapeutics
ISSN: 2161-0665 Pediatrics and Pediatric Gastroenterology 2018
March 21-22, 2018
16th Annual World Congress on
3rd Annual World Congress on
March 21-22, 2018 | New York, USA
PEDIATRICS
PEDIATRIC NUTRITION,
GASTROENTEROLOGY & CHILD DEVELOPMENT
&
Does microalbuminuria level correlate with PRISM and PELOD scores in critically ill children and
prediction of mortality
Karan Raheja, Anil Sachdev, Dhiren Gupta, Suresh Gupta and Neeraj Gupta
Sir Ganga Ram Hospital, India
Introduction: Microalbuminuria (MA), a sub-clinical increase in urinary albumin, is a recognized marker of systemic inflammation,
and is thought to reflect the glomerular component of a systemic capillary leak. Previous research has shown that sustained MA is
associated with the development of organ dysfunction later on and poor outcome in adults. To date, the relationship of MA and organ
system dysfunction (OSD) in critically ill children have not been systematically evaluated. The purpose of this study was to examine
the relationship between MA and OSD in critically ill children.
Methods: Eligible subjects were patients <16 years and more one month of age, who were admitted to the PICU, and with anticipated
to stay >24 hrs. Patients with primary nephropathies or gross hematuria were excluded. Microalbuminuria (ACR) were obtained
from each patient at admission (ACR1), at 12hrs (ACR2) and at 24hrs (ACR3) and expressed in mcg/mg of creatinine. Cut off for
significant microalbuminuria was taken as 180mcg/mg. Daily PELOD scores were calculated for each patient and PRISM score at 12
and 24 hours. Correlations between PRISM and PELOD with microalbuminuria were calculated. Also we tried to find out survivor
and non-survivor correlation with microalbuminuria.
Results: The sample included 138 patients, with sepsis with a median age of 38 months (range 1 to 192), median weight 13kgs (range
2.4 to 69), median PRISM score in patient with microalbuminuria levels >180mcg/mg was high 8 (range 6 to 12) in comparison
to others in which levels was <180mcg/mg 4 (range 2 to 8) and median PELOD scores was high 21 (range 12 to 23) in group
with microalbuminuria levels >180mcg/mg to others with levels <180mcg/mg 9 (range1 to 20). There is also statistically significant
difference between types of sepsis in case of microalbuminuria at admission, 12hrs and 24hrs P=0.01 (P<0.05). Using Mann-Whitney
test used for comparison between 2 groups (survivors vs. non-survivors) showed that there is no statistically significant difference
between outcome in case of microalbuminuria on admission P=0.256 (P>.05). But, there is statistically significant difference between
outcome in case of microalbuminuria at 12hrs P=0.037 (P<0.05) and 24hrs P=0.016 (P<0.05).
Conclusions: This study demonstrates a significant correlation betweenmicroalbuminuria and the degree of organ systemdysfunction
in critically ill children. It also suggests that rising microalbuminuria is predictive of worsening organ dysfunction and increased risk
of mortality if the trends were gradually increasing. Microalbuminuria can be rapidly determined, is inexpensive, blood sparing, and
it may have a role in the clinical assessment of the critically ill child.
Pediatr Ther 2018, Volume: 8
DOI: 10.4172/2161-0665-C1-049