背景:在慢性肾脏病(CKD)透析患者中,频繁的静脉穿刺监测血清尿素和肌酐会导致静脉损伤和感染。在这项研究中,我们评估了使用唾液样本替代血清样本来测定接受透析的CKD患者的尿素和肌酐水平的可行性.方法研究参与者包括50例接受血液透析的CKD患者和同等数量的健康个体。我们测量了正常人的血清和唾液中尿素和肌酐的水平。CKD患者在血液透析之前和之后也进行了类似的调查。结果在我们的研究中,我们发现,病例组中唾液尿素和肌酐的平均值显着升高(唾液尿素:99.56±43.28mg/dL,唾液肌酐:1.10±0.83mg/dL)与对照组(唾液尿素:33.62±23.84mg/dL,唾液肌酐:0.15±0.12mg/dL,p值:<0.001)。透析后样本中唾液尿素和肌酐的平均值有统计学上的显着降低(唾液尿素:45.06±30.37mg/dL,唾液肌酐:0.43±0.44mg/dL)与透析前样品(唾液尿素:99.56±43.28mg/dL,病例组唾液肌酐:1.10±0.83mg/dL;p值:<0.001)。唾液尿素与血清尿素呈显著正相关(r值:0.366,p值:0.009)。但是唾液和血清肌酐之间没有显着相关性。我们已经创建了唾液尿素(52.5mg/dL)的临界值来诊断CKD,其具有良好的敏感性(84%)和特异性(78%)。结论我们的研究结果表明,唾液尿素和肌酐的估计可以作为一个非侵入性的,CKD诊断的替代标志物,并在血液透析前后无风险监测其进展中受益。
Background Frequent venepuncture for monitoring of serum urea and creatinine in chronic kidney disease (CKD) patients on dialysis will result in venous damage and infection. In this research, we assessed the feasibility of utilizing salivary samples as a substitute for serum samples in determining the levels of urea and creatinine in patients with CKD undergoing dialysis. Methods The study participants included 50 patients diagnosed with CKD undergoing hemodialysis and an equal number of apparently healthy individuals. We measured the serum and salivary levels of urea and creatinine in normal subjects. CKD patients were also subjected to similar investigations both before and after hemodialysis. Results In our study, we found that the mean value of salivary urea and creatinine are significantly elevated in the
case group (salivary urea: 99.56 ± 43.28 mg/dL, salivary creatinine: 1.10 ± 0.83 mg/dL) as compared to the control group (salivary urea: 33.62 ± 23.84 mg/dL, salivary creatinine: 0.15±0.12 mg/dL, p value: <0.001). There was a statistically significant reduction in the mean value of salivary urea and creatinine in the post-dialysis sample (salivary urea: 45.06 ± 30.37 mg/dL, salivary creatinine: 0.43±0.44 mg/dL) compared to the pre-dialysis sample (salivary urea: 99.56 ± 43.28 mg/dL, salivary creatinine: 1.10 ± 0.83 mg/dL; p value: <0.001) in the
case group. The salivary urea is significantly positively correlated with serum urea (r value: 0.366, p value: 0.009). But there is no significant correlation seen between salivary and serum creatinine. We have created a cut-off for salivary urea (52.5 mg/dL) to diagnose CKD which has a good sensitivity (84%) and specificity (78%). Conclusion The results of our study suggest that the estimation of salivary urea and creatinine could serve as a non-invasive, alternative marker for the diagnosis of CKD, and benefit in risk-free monitoring of their progress before and after hemodialysis.