Urinary microalbumin as a surrogate marker of sequential organ failure assessment – defined organ dysfunction in sepsis

Manoj Kumar Mathur; Savinay Mehrotra; Poonam Gupta; Ajeet Kumar Chaurasia

doi:10.18203/2349-3933.ijam20263716

Authors

Manoj Kumar Mathur Department of Medicine, Moti Lal Nehru Medical College, Prayagraj, Uttar Pradesh India
Savinay Mehrotra Department of Medicine, Moti Lal Nehru Medical College, Prayagraj, Uttar Pradesh India
Poonam Gupta Department of Medicine, Moti Lal Nehru Medical College, Prayagraj, Uttar Pradesh India
Ajeet Kumar Chaurasia Department of Medicine, Moti Lal Nehru Medical College, Prayagraj, Uttar Pradesh India https://orcid.org/0009-0008-3887-9731

DOI:

https://doi.org/10.18203/2349-3933.ijam20263716

Keywords:

Sepsis, Urinary microalbumin, Microalbuminuria, SOFA Score, Organ dysfunction, Endothelial dysfunction, Biomarkers, Risk stratification, Critical care

Abstract

Background: Sepsis causes dysregulated host responses to infection, endothelial injury, increased vascular permeability, and organ dysfunction. Urinary microalbumin reflects endothelial dysfunction and capillary leak, but its relationship with organ dysfunction severity requires further evaluation.

Methods: This hospital-based observational cross-sectional study was conducted in a tertiary care teaching hospital between 2025-2026. One hundred adults with sepsis were enrolled. Urinary microalbumin was measured at presentation and SOFA scores were calculated. Clinical, laboratory, and outcome-related variables were compared across sequential organ failure assessment (SOFA) severity categories. Pearson correlation was used to assess the relationship between urinary microalbumin and SOFA score.

Results: Out of 100 patients, 35% had mild, 51% moderate, and 14% severe organ dysfunction. Mean urinary microalbumin increased from 49.62±28.45 mg/l in mild dysfunction to 77.60±49.05 mg/l in moderate and 116.64±74.16 mg/l in severe dysfunction (F=10.17, p<0.001). Urinary microalbumin correlated positively with SOFA score (r=0.368, p<0.001). Increasing SOFA severity was associated with lower MAP and GCS, higher blood urea nitrogen, creatinine levels, greater vasopressor and mechanical ventilation requirements.

Conclusion: Urinary microalbumin was significantly associated with SOFA-defined organ dysfunction severity in sepsis. It may serve as a simple, non-invasive adjunct biomarker for early severity assessment and risk stratification.

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