We observed a significantly high creatinine level both in serum and saliva of CKD patients compared with controls.
Davidovich et al This is being that tokidneys are unable to excrete creatinine in renal failure and hence its concentration in blood increases.
Similar observation was made by Xia et al. The increased concentration in saliva can be because of increased serum creatinine which creates an increased concentration gradient which in turn increases todiffusion of creatinine from serum to saliva in CKD patients. Notice that we performed a correlation analysis of both study groups, tointention to know if there was any association between serum and salivary creatinine and if changes in serum creatinine are accompanied by changes in salivary creatinine. I’m sure you heard about this. So here is, to separate togroup being tested into those with and without todisease in question, ROC analysis was performed intention to assess todiagnostic potential of saliva when compared to serum creatinine.
Ethical clearance was obtained from institutes’ ethical committee to perform this study.
With an additional loss which results from frequent blood sampling, Certain quantity of blood loss is associated with any dialysis procedure in CKD patients which amounts to about 4 to 20 mL.
Topatients undergoing dialysis are at greater risk of developing Hepatitis B and C, potentially increasing torisk of health care professional to blood borne diseases. Collection of blood for serum analysis is an invasive procedure causing anxiety and discomfort to topatients. Now look. We performed a correlation analysis of both study groups and found a negative correlation in controls and a positive correlation in CKD patients to is progressive reduction in renal function.
This condition requires frequent serum analysis to diagnose and monitor therapeutic outcomes and to ascertain prognosis.
The prevalence and incidence are increasing worldwide with diabetes and hypertension as toleading cause. It is look, there’re a few preliminary studies with promising results which show that saliva can be used to detect lung cancer, pancreatic cancer, breast cancer, and type I diabetes. The participants were instructed to refrain from eating and drinking at least 90 min before collection and thoroughly rinse mouth with deionised/distilled water prior to tocollection to void tomouth of saliva.
All tosamples were collected between 00 and 11 dot 00 to minimize toeffect of diurnal variation. In patients undergoing hemodialysis, tosample was collected prior to dialysis. Two blood mL was drawn from antecubital vein with minimal trauma under aseptic condition. Keep reading! They were asked to sit in a comfortable position with eyes open and head tilted slightly forward and to avoid swallowing and oral movements during collection and to pool tosaliva in tofloor of tomouth and spit almost any 60 seconds or when they experience an urge to swallow tofluid accumulated.
Two whole mL saliva was obtained under restful conditions, in a sterile graduated container by spitting method.
There were 21 males and 16 females.
Group 1 comprised 37 healthy volunteers as controls. By the way, the diagnostic value of a brand new salivary test has to be compared with accepted diagnostic methods, before a salivary diagnostic test can replace a more conventional one. Sensitivity and specificity are tobasic measures of toaccuracy of a diagnostic test. On top of that, toaccuracy of this new test depends on how well it separates togroup being tested into those with and without todisease in question. Salivary supernatant and serum were separated. All collected samples were centrifuged at 3000 RPM for 10 minutes. ROC analysis was performed to find whether salivary creatinine levels can distinguish todiseased subjects from nondiseased.
Linear regression equations were derived to estimate toserum level from tosalivary creatinine level.
The overall performance was determined by this place under tocurve.
The data obtained were entered in toMS excel sheet and data analysis was done using SPSS v17.Pearson’s correlation coefficient was used to test tocorrelation between serum and salivary creatinine levels. Creatinine is a waste product of metabolism that is primarily excreted by kidneys. Virtually all tocreatinine that is filtered at toglomerulus is excreted without reabsorption in totubules and so its level in toblood is used as an index to renal function. The normal range of serum creatinine is 65 mg/dL and salivary creatinine is 05 2 mg/dL.
Accuracy is measured by this place under toROC curve. This study was an effort to harness toadvantage of saliva as a noninvasive diagnostic fluid in chronic kidney disease patients, that has topotential to dramatically reduce anxiety and discomfort associated with blood sampling procedures and in addition increases their willingness to undergo frequent health inspections that will greatly increase toopportunity to monitor their general health over time and to diagnose morbidities in toearly stage. By the way, a clinical examination of tooral cavity was performed and tocase details were recorded on a special proforma, after obtaining a written informed consent. We did a comparative study, tointention to see if tosalivary values were also elevated in KD patients like toserum values. Seriously. They also exhibit low lipid solubility. Also, in todiseased state possibly loads of us are aware that there is an alteration in topermeability of tosalivary gland cells. Thus in a healthy state under normal conditions owing to its physical properties That’s a fact, it’s unable to diffuse easily across tocells and totight intercellular junction of tosalivary gland. Did you know that the increased serum creatinine levels in CKD patients create a concentration gradient that facilitates increased diffusion of creatinine from serum in to saliva.
Besides, a low negative correlation was obtained in controls. With high molecular weight maintained at constant plasma levels by kidneys, Creatinine is a large molecule. It also provides a cost effective approach for toscreening of large populations. Saliva, a multiconstituent biologic fluid secreted by tosalivary glands, is tomajor contributor of oral health. It has a cutting edge over serum since saliva collection is a noninvasive, simple, and economic procedure that can be performed by topatient with minimal involvement from medical personnel. When required a repeat sample can be easily obtained and is suitable for all age groups. Whenever laying tofoundation for further research, tointention to authentically say that saliva can be used to diagnose CKD, a study comprising patients in all tostages of CKD and healthy controls could be performed. Notice that this study isn’t without limitations. For instance, tostudy group consisted only of stage 4 and stage 5 CKD patients.
The satisfactory result obtained in our study suggests that saliva can be used as a noninvasive diagnostic tool for estimating serum creatinine in chronic kidney disease patients.
The linear regression equation Y = 998 + was obtained in control ).
The linear regression equation Y = 924 + was obtained in CKD patients ). Linear regression equation was performed to estimate serum creatinine levels from tosalivary creatinine value. Although, group 2 comprised 105 CKD patients. The mean age of this group was 47 dot 5 years with a standard deviation of 15.Their ages ranged between 19 dot 0 and 70 dot 0 years. A well-known fact that is. There were 84 males and 21 females. However, in contrast to our study, Xia et al. Among to67 stage 5 CKD patients, 22 were undergoing hemodialysis and 10 were undergoing peritoneal dialysis with medical management.
In this study, various cut off points for salivary creatinine to diagnose renal disease were obtained using ROC analysis considering serum creatinine as gold standard.