MON-195 TO STUDY CORRELATION OF NAIL CREATININE WITH SERUM CREATININE IN CHRONIC KIDNEY DISEASE STAGE Vd & IN RENAL TRANPLANT RECIPIENT.

Abstract

Kidney disease is a global health problem. According to the World Health Organization, approximately 850,000 patients develop End Stage Kidney Disease (ESKD) every year. It was postulated that the concentration of creatinine in fingernail and toenail clippings might be of value in distinguishing acute from chronic azotemia. As there are very few studies done based on this hypothesis, we conducted the study to find out whether fingernail creatinine can correlate with serum creatinine in chronic kidney disease and to identify the change in finger nail concentration with enhancing renal function after renal transplant. OBJECTIVE: - To assess nail creatinine in relation with serum creatinine in patients with Chronic Kidney Disease on hemodialysis and to study its profile in patients who have undergone kidney transplant. A prospective, observational cohort study conducted at tertiary health care centre, 20 patients were selected for the study. Out of which 10 patients were diagnosed as chronic Kidney disease (CKD Vd) with more than 30 days of dialysis vintage, 10 CKD patients who underwent kidney transplant were followed-up for three months post transplant. 10 healthy volunteers were included in the study as controls. The Nail creatinine was extracted in water first by pulverization, followed by mechanical powdering. Sample powder incubated at 45°C for 2 hrs, centrifuged and then assayed by Alkaline Picrate-method on semi Auto Biochemistry Analyzer (Robonik). In our study, control group had mean serum creatinine of 0.78 ± 0.13 mg/dl and nail creatinine of 33.99±4.55 µg/g; while the mean of serum creatinine was 9.56±4.19 mg/dl and nail creatinine was 90.05±19.72 µg/g in CKD Vd group. In Post renal transplant patients, the serum creatinine on the day of transplant [Month (M) 0] was 9.07±1.62 mg/dl and on three month (M1, M2, M3) follow-up, the serum creatinine were 1.41±0.31mg/dl, 1.31±0.37mg/dl, 1.31±0.33mg/dl respectively. The nail creatinine on the day of transplant (M 0) was 85.01±23.66 µg/g and on serial measurements for three month (M1, M2, M3) the nail creatinine levels were 61.58±15.93µg/g, 44.66±8.95µg/g, 41.16±15.56µg/g respectively. We found that, nail creatinine levels in CKD Vd group was higher than Control groups (p-value 0.001). Though nail creatinine levels in patients who underwent renal transplant were similar to those in CKD Vd patients initially, nail creatinine level gradually reduced and reached values comparable to that of control group. Hence, nail creatinine correlate with serum creatinine level in patients with chronic kidney disease.