Assessment of microalbuminuria in hypertensive patients with established coronary artery disease

Ischemic modified albumin increases in acute kidney injury

Purpose: Acute kidney injury (AKI) is a severe kidney disease carrying high morbidity and mortality. An ischemic process, at the cellular level, has been detected prior to the full-blown AKI. An elevated ischemic modified albumin (IMA) was also found to be increased fast at several minutes following an ischemic process in the body. In this connection, we have investigated, in advance, the changes of IMA concentrations in patients with possible AKI. Methods: IMA and other biochemical and haematological parameters were measured in sera of thirty nine patients with AKI and of thirty eight healthy controls. AKI is defined by an increase in serum creatinine by ≥ 0.3 mg/dl in 48 hours or an increase by ≥ 1.5-fold from a known or assumed baseline. The results in the two groups were compared. Results: IMA, creatinine, blood urea nitrogen, white blood cell, neutrophil, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and mean platelet volume were found to be higher in patients with AKI than in healthy controls. In contrast, total protein, albumin, lymphocyte, and haemoglobin were lower in patients with AKI than in healthy controls. No significant difference was recorded in platelet counts between the two groups. Conclusion: Our results indicate that increased levels of NLR and PLR play a central role in a systemic inflammation in AKI. Monitoring serum IMA could be a useful tool in the assessment of AKI.