Forthcoming Issue Vol. 20 No. 1 The association between urinary albumin creatinine ratio and mortality in children with sepsis
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Abstract
Background. In pediatric populations, sepsis is a major cause of admission to the Pediatric Intensive Care Unit (PICU). Microalbuminuria, as measured by the urinary albumin-to-creatinine ratio (ACR), significantly contributes to mortality rates among children with sepsis.
Objective. This study aims to investigate the association between urinary ACR and mortality in pediatric patients with sepsis.
Methods. This was a prospective cohort study conducted in the PICU of Prof. Dr. R. D. Kandou General Hospital, Manado, from March to October 2024. Pediatric sepsis was assessed using the Phoenix Score.
Results. A total of 60 patients were enrolled in the study, with a median age of 108 months (IQR: 48–168 months). Urinary ACR was significantly associated with ventilator use (p = 0.035). The severity of sepsis showed a strong and significant correlation with urinary ACR (r = 0.561; p < 0.001). The median urinary ACR in deceased patients was 100.78, compared to 30.72 in survivors (p = 0.023). The optimal urinary ACR cut-off value for predicting mortality was 38.75, with a sensitivity of 84.6% and specificity of 61.7% (AUC = 0.71; p = 0.023). Urinary ACR was significantly associated with ventilator use [OR (95% CI) = 2.35 (1.15–4.79); p = 0.019], sepsis severity [OR (95% CI) = 0.30 (0.08–0.52); p = 0.007], and patient mortality [OR (95% CI) = 2.32 (1.15–4.68); p = 0.018].
Conclusion. Elevated urinary ACR was associated with increased mortality risk in children with sepsis.
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References
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