Correlation of glomerular permeability, endothelial injury, and postoperative multiple organ dysfunction

Kaoru Koike, Junichi Aiboshi, Yotaro Shinozawa, Kazuhiko Sekine, Tomoyuki Endo, Yasuhiro Yamamoto

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Purpose. To determine whether the degree of microalbuminuria correlates with the extent of endothelial cell injury, the severity of illness, and the magnitude of multiple organ dysfunction in patients who undergo emergency surgery. Methods. We measured the urinary albumin: creatinine ratio (ACR) within 24h after surgery in 31 patients and examined its relationship with various clinical measurements. Results. The ACR increased during the first 24h post-operatively. The log ACR correlated with the serum thrombomodulin concentration measured on the same day, but not with the level of plasma von Willebrand factor antigen. The increase in the log ACR correlated with the acute physiology and chronic health evaluation score (APACHE III), the simplified acute physiology score, the multiple organ dysfunction score, and the score of sequential organ failure assessment (SOFA) calculated on the same day, and the blood volume lost during the operation. The log ACR did not correlate with the white blood cell count or the serum C-reactive protein measured at the same time. The log ACR correlated with SOFA on postoperative days 3, 7, and 10, and mortality increased in accordance with the increase in log ACR. Conclusions. The urinary ACR correlated with the extent of endothelial cell injury, the severity of illness, and the magnitude of multiple organ dysfunction.

Original languageEnglish
Pages (from-to)811-816
Number of pages6
JournalSurgery today
Volume34
Issue number10
DOIs
Publication statusPublished - 2004 Oct 18

Keywords

  • APACHE III
  • Endothelial injury
  • Microalbuminuria
  • Multiple organ dysfunction syndrome
  • Surgery

ASJC Scopus subject areas

  • Surgery

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