Hubungan Rasio Albumin Kreatinin Urin (uACR) terhadap Kejadian Acute Kidney Injury pada Pasien Sepsis di RS Adam Malik

Abstract

Background: Sepsis is the most common cause of Acute Kidney Injury (AKI). Diagnosis of AKI based on serum creatinine (sCr) has limitations, sCr increases only after >50% kidney function is lost. uACR examination is a simple test to assess microalbuminuria which reflects impaired kidney function. Objective: Analyzing the correlation between uACR and AKI incidence in sepsis patients treated at Adam Malik Hospital. Methods: The study design was observational analytic with prospective cohort design. Samples were taken consecutively. Sepsis diagnosis was based on qSOFA score. uACR and sCr I were checked <24 hours after sepsis was diagnosed, sCr II was rechecked 48 hours later to assess the occurrence of AKI. Data were analyzed using SPSS. Results: There were 52 study subjects, predominantly male (57,7%), with an average age of 52,5±16,42 years, and the most common source of infection was the lungs (82,7%). AKI occurred in 46,2% of study subjects. The AUC area of uACR as a predictor of AKI was 75,2%. The independent variable that significantly influenced AKI was uACR (p<0,001). The uACR cut-off was 225 mg/g, with a sensitivity of 83,3%, a specificity of 67,9% and an accuracy rate of 75%. uACR levels ≥225 mg/g had a 10,556 times risk of AKI. Conclusion: There is a significant correlation between uACR and the incidence of AKI so it can be used as a predictor of AKI in sepsis patients.