Efficacy of Salivary Urea and Creatinine Compared to Serum Levels in Chronic Kidney Disease Patients: A Cross-sectional Study
Introduction: Chronic Kidney Disease (CKD) has become an impending health concern due to the massive rise in the number of patients with diabetes mellitus and hypertension. Monitoring CKD patients typically requires regular invasive testing, and a simple diagnostic test that does not involve ven...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2024-01-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://www.jcdr.net/articles/PDF/18905/66040_CE[Ra1]_F(IS)_QC&REF(KK_IS)_PF1(VD_DK_OM)_PFA(VD_KM)_PN(KM).pdf |
| Summary: | Introduction: Chronic Kidney Disease (CKD) has become an
impending health concern due to the massive rise in the number
of patients with diabetes mellitus and hypertension. Monitoring
CKD patients typically requires regular invasive testing, and a
simple diagnostic test that does not involve venipuncture would
greatly benefit patients and healthcare professionals. Extensive
research is being conducted to explore the use of saliva as a
Non invasive tool for evaluation of systemic diseases like CKD.
However, most of these studies have focused on End Stage
Renal Disease (ESRD) patients.
Aim: To investigate the correlation between salivary urea and
creatinine levels and their serum counterparts in CKD patients
and healthy controls. Additionally, the study aimed to assess the
efficacy of salivary urea and creatinine compared to serum urea
and creatinine in predicting CKD.
Materials and Methods: The present cross-sectional study
was conducted between January 2021 and July 2022 in
the Department of Biochemistry, in collaboration with the
Department of Medicine, at Heritage Institute of Medical
Sciences in Varanasi, Uttar Pradesh, India. The study included
a total of 60 participants: 30 CKD patients (stage 1-3) and 30
age-matched healthy controls. Serum and salivary urea were
analysed using the Urease-Glutamate Dehydrogenase (GLDH)
method, and creatinine was measured using the Modified Jaffe’s
method on the Dirui-300B autoanalyser. Data were statistically
analysed using Pearson’s correlation coefficient. The sensitivity,
specificity, and Area Under the Curve (AUC) of salivary urea
and creatinine were evaluated in comparison to their serum
counterparts.
Results: The participants consisted of 30 CKD patients with
a mean age of 54.8±8.8 years and 30 age-matched healthy
controls with a mean age of 52.42±8.4 years. A significant
difference in salivary urea and creatinine levels was observed
between the control and CKD groups. There was a strong and
significant correlation (p-value <0.01) between salivary creatinine
and serum creatinine in both the control group (r-value=0.76)
and the CKD group (r-value=0.82). Additionally, a strong and
significant correlation (p-value <0.01) was found between
salivary urea and serum urea in the CKD group (r-value=0.63).
However, the correlation between salivary and serum urea was
not significant in the control group, with an r-value of 0.58 and a
p-value of 0.24. Both salivary urea and creatinine demonstrated
high sensitivity (90% and 89%, respectively), specificity (80%
and 80%, respectively), and AUC (0.78 and 0.86, respectively)
compared to their serum counterparts, validating their practical
clinical utility.
Conclusion: The concentration of urea and creatinine in saliva
can reflect kidney damage and help monitor kidney function
in CKD patients. Standardising the protocol for evaluation of
salivary urea and creatinine and establishing a reference range
will make it useful for screening for CKD. |
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| ISSN: | 2249-782X 0973-709X |