Discrepancies of Serum Creatinine Levels among CKDu Patients in Kebithigollawa, Sri Lanka: Retrospective Study

Abstract

Chronic kidney disease of uncertain etiology (CKDu) in Sri Lanka has become a major health issue. It is characterized by lacking a causal association with risk factors such as diabetes, urinary tract infection and hypertension while the diagnosis is based on kidney dysfunction markers including creatinine in blood or urine, with derived indices such as eGFR. The study presumed that creatinine levels may show seasonal variation so that its dependability should need assessment. Data were collected from volunteers (n=17) selected from about one hundred patients of CKDu at Ayruveda therapeutic clinic of Kebithigollawa which is in the north central province, the most affected in the country. The selection criteria included the availability of investigation records spanning creatinine, protein, and albumin as well as Calcium levels in serum over last three years with concurrent occupation in paddy farming. Results showed fluctuations in serum creatinine levels with a seasonal trend. Individual comparison of creatinine levels indicated a general tendency of having peak values in the periods between February & April and again in July & August which coincide with Maha and Yala paddy cultivations respectively. Additionally, mean creatinine levels over the duration either increased (n=7) or decreased (n= 5) by 31 and 24% respectively perhaps due to self-care differences. Other parameters did not show noticeable trends during the period. In summary, variations of serum creatinine levels may occur in CKDu-diagnosed people coinciding with the seasons of paddy cultivation.