Biochemical Evaluation of the Effectiveness of Salivary Urea and Creatinine Levels and Their Relationship with Serum Urea and Creatinine Levels in Patients with Chronic Kidney Disease

Abstract

Background: Individuals with chronic kidney disease (CKD) often experience blood loss as a result of treatments like hemodialysis and routine blood samples. The submandibular, sublingual and parotid salivary glands produce saliva, and this biological fluid is crucial to both dental and overall health. Saliva collection is easy, does not need much expertise, and has several benefits over serum. Regardless of age, regular saliva collection is safe and effective. In Pakistan there is a less attention of physicians, surgeon, and dentists on the importance of saliva in diagnostic field. Objective: This study has two main objectives, first is to determine the efficacy of urea and creatinine in saliva and the second was to find out any association with creatinine and urea levels in serum amongst CKD. Study Design: This is cross sectional study. Settings: This study was conducted at Department of Biochemistry Central Park Medical College, Lahore Pakistan. Duration: February 2022 to July 2022. Methods: Total 50 saliva and serum sample were taken in this study form the patients with stage four and five of CKD. The urea and creatinine were estimated in saliva and serum samples, collected from CKD patients. The statistical analysis was done by using SPSS version 20. Results: Out of sixty patients with stages 4 and 5 CKD, total 44 male and 16 female were enrolled in the study. Total age range 16 to 55 years with the mean of 24.67 ± 4.14 years. However, the BMI range 16 to 33 Kg/m² with 21.7 ±3.8 Kg/m² were calculated. The ROC analysis confirmed that the overall area under the curve was 0.967 (95% CI: = 0.937-0.997, standard error = 0.015) of urea analysis. Conclusion: The levels of urea and creatinine in the saliva of people with severe CKD were shown to be considerably higher and strongly correlate with blood levels. ROC analysis shows that salivary creatinine and urea have good specificity and sensitivity. The present study found that the levels of creatinine and urea in the blood are positively correlated with those in the saliva. Collecting a patient's saliva instead of blood for CKD diagnosis and monitoring is a less painful option.