Salivary creatinine and urea in patients with end-stage chronic kidney disease could not be used as diagnostic biomarkers for the effectiveness of dialysis treatment

Abstract

Introduction. End-stage chronic kidney disease (CKD) is characterized by kidney failure with the organ’s functions reduced or lost completely, where the kidneys are incapable of filtering excess fluids. Renal replacement therapy may be provided by peritoneal dialysis, hemodialysis or renal transplantation. Among the key indicators for tracking patients’ current status are urea and creatinine levels.

Aim. The study analyzed saliva as a medium to detect and measure urea and creatinine levels in end-stage CKD patients as well as to use it as criteria for the effectiveness of the dialysis treatment by comparing salivary urea and creatinine levels with their blood levels.

Material and methods. The study targeted 70 end-stage CKD patients from northeastern Bulgaria undergoing hemodialysis treatment. The urea in blood serum was carried out using the UV kinetic method. Creatinine levels were measured using Jaffe reaction colorimetric method without deproteinezation, adapted on an Olympus AU 400 automated biochemical analyzer (Beckman Coulter Inc., USA). Samples from whole unstimulated saliva were collected in a 15 ml sterile test tube as per Navazesh method. The qualitative determination of salivary urea was performed using the UV kinetic method. Creatinine levels in whole unstimulated saliva were measured using Jaffe reaction colorimetric method.

Results. There was a statistically significant reduction in blood urea levels (P=0.000) and in blood creatinine levels (P = 0.000) following hemodialysis. The results revealed that there was no statistically significant dependence between both, the urea levels (P=0.240) and the creatinine levels (P=0.065) in whole unstimulated saliva obtained prior to and after a hemodialysis.

Conclusion. Despite the parallel increase of the urea and creatinine levels in blood serum and in whole unstimulated saliva in end-stage CKD, salivary urea and creatinine levels could notbe used as diagnostic biomarkers for the effectiveness of dialysis treatment.

 

Key words: end-stage chronic kidney disease, dialysis, salivary urea, salivary creatinine

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La Nefrologia nella Regione Sicilia

Regione Sicilia

 

 

 

 

 

 

In Sicilia come anche in altre Regioni d’Italia, la sanità è in una fase di profonda trasformazione strutturale di natura organizzativa volta a ridurre gli sprechi, le inefficienze e a migliorare l’accoglienza, non solo alberghiera, ma anche e soprattutto umana al fine di garantire ai pazienti un rapido e qualificato accesso alle strutture sanitarie dell’Isola e rispondere così, al meglio, ai bisogni di Salute dei Siciliani.

 

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The contribution to nephrology of Professor Joseph Erden

Abstract

Professor Josef Erben, MD, DSc. died on May 24, 2015 in Hradec Králové, Czech Republic. He was one of the most outstanding Czechoslovak medical personalities who lived in the 20th and at the beginning of the 21st century. His work significantly influenced the development of general internal medicine and clinical nephrology, especially renal replacement therapy and kidney transplantation. He finished his medical studies at the Medical School of Charles University in Hradec Králové in 1951. From 1956 to 1993 he worked at the 1st Internal Clinic in Hradec Králové. From 1990 to 1993 he was the Head of this Clinic. Professor Erben’s principal contributions were at the national level: 1) He was a founder of regular dialysis treatment of chronic renal failure in Czechoslovakia; 2) He designed the project and production of the Hradec hemodialysis system; and at the international level: 3) Using the Subclavian vein, as vascular access for hemodialysis; 4) The development of a hemodialysis coil of Czechoslovak production of the Chiradis type for hemodialysis.

Keywords: clinical nephrologist, dialysis; subclavian vein catheterization; simultaneous hemodialysis system, scientist and organizer

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