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Urine Microalbumin and Albumin-Creatinine Ratio in COPD: Implications for Perioperative and Cardiovascular Risk
Authors: Ravi Shankar Mishra, Yusuf Barkati, Mazher Maqsood, Anjali Chauhan, Pradeep Nirala, Abhishek Kumar, Chinmay Jethi
DOI: 10.18231/j.ijirm.11865.1809767044
Keywords: Chronic Obstructive Pulmonary Disease, Microalbuminuria, Albumin-Creatinine Ratio, Endothelial Dysfunction, Systemic Inflammation, Perioperative Risk, Cardiovascular Comorbidity
Abstract: Abstract Background: Chronic obstructive pulmonary disease (COPD) is associated with systemic inflammation and cardiovascular comorbidities that influence perioperative and critical care outcomes [1]. Urinary microalbumin and the albumin-creatinine ratio (UACR) reflect endothelial dysfunction and microvascular disease [2,3]. We evaluated their association with COPD severity and considered their potential utility in perioperative risk assessment. Methods: In this observational study, stable COPD patients were stratified by Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria [4]. Spot urine samples were collected and analyzed for albumin and creatinine, and the UACR was calculated [5]. We compared UACR across COPD severity groups and examined correlations with lung function and oxygenation indices [6]. Results: Consistent with prior reports, patients with advanced COPD had significantly higher urine microalbumin levels and UACR than those with mild disease [7]. UACR increased progressively from GOLD stage I to IV [6,8]. In our cohort, higher UACR was inversely correlated with FEV₁ and PaO₂ (p<0.01) and positively associated with symptom burden and hypoxemia, indicating systemic capillary leak in severe COPD [9,10]. Conclusions: Urine microalbuminuria and elevated UACR identify COPD patients with greater systemic vascular dysfunction and hypoxemia [3,7]. Given their established prognostic value in cardiac surgery and critical care, these markers may help anesthesiologists assess cardiovascular risk in COPD patients [11,12]. Routine preoperative screening for microalbuminuria could prompt intensified cardiovascular optimization and postoperative monitoring in this high-risk population [13]