Salivary creatinine estimation as an alternative to serum creatinine in chronic kidney disease patients.

Vasupradha Govindarajan,Karthikshree V Prashad,Balamurali Pennagaram Dhanasekaran,Sreejith Parameswaran,Nirima Oza,Ramesh Venkatapathy

doi:10.1155/2014/742724

Abstract

Context. Sampling blood for serum analysis is an invasive procedure. A noninvasive alternative would be beneficial to patients and health care professionals. Aim. To correlate serum and salivary creatinine levels and evaluate the role of saliva as a noninvasive alternative to serum for creatinine estimation in chronic kidney disease patients. Study Design. Case-control study. Methods. Blood and saliva samples were collected from 37 healthy individuals and 105 chronic kidney disease patients. Serum and salivary creatinine levels were estimated using automatic analyser. Statistical Analysis. The serum and salivary creatinine levels between controls and cases were compared using t-test. Correlation between serum and salivary creatinine was obtained in controls and cases using Pearson correlation coefficient. Receiver operating characteristic analysis was done to assess the diagnostic performance of salivary creatinine. Cut-off values were established for salivary creatinine. Results. Serum and salivary creatinine levels were significantly higher in CKD patients than controls. The correlation was negative in controls and positive in cases. Area under the curve for salivary creatinine was found to be 0.967. A cut-off value of 0.2 mg/dL gave a sensitivity of 97.1% and specificity of 86.5%. Conclusion. Saliva can be used as a noninvasive alternative to serum for creatinine estimation.

Highlights

Chronic kidney disease (CKD) is progressive reduction in renal function
Certain amount of blood loss is associated with each dialysis procedure in CKD patients which amounts to about 4 to 20 mL, with an additional loss which results from frequent blood sampling [3]
The study population comprised 105 patients already diagnosed with chronic kidney disease (CKD) and 37 healthy volunteers who had no complaint or major illness in recent past were selected as controls

Summary

Introduction

Chronic kidney disease (CKD) is progressive reduction in renal function. The prevalence and incidence are increasing worldwide with diabetes and hypertension as the leading cause [1]. This condition requires frequent serum analysis to diagnose and monitor therapeutic outcomes and to ascertain prognosis. Creatinine, a waste product of muscle metabolism, is primarily excreted by kidneys and its level in serum is used as an index to renal function [2]. Collection of blood for serum analysis is an invasive procedure causing anxiety and discomfort to the patients. The patients undergoing dialysis are at greater risk of developing Hepatitis B and C [4, 5], potentially increasing the risk of health care professional to blood borne diseases. A simple diagnostic test that provides a reliable evaluation of disease status and stages would be of value to both the clinicians and the patients

Methods

Discussion

Conclusion