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Yuan Y, He Y, Pei D, Tong L, Hu S, Liu L, Yi X, Wang J. Urease-Functionalized Near-Infrared Light-Responsive Gold Nanoflowers for Rapid Detection of Urea by a Portable Pressure Meter. Microchem J 2022. [DOI: 10.1016/j.microc.2022.107450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Lin TL, Evans RD, Unwin RJ, Norman JT, Rich PR. Assessment of Measurement of Salivary Urea by ATR-FTIR Spectroscopy to Screen for CKD. KIDNEY360 2021; 3:357-363. [PMID: 35373139 PMCID: PMC8967637 DOI: 10.34067/kid.0004362021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 12/13/2021] [Indexed: 01/10/2023]
Abstract
Stages of CKD are currently defined by eGFR and require measurement of serum creatinine concentrations. Previous studies have shown a good correlation between salivary and serum urea levels and the stage of CKD. However, quantitative salivary urea assays in current clinical use require costly and labor-intensive commercial kits, which restricts the advantage of using saliva and limits wider applicability as a quick and easy means of assessing renal function. Attenuated total reflection Fourier-transform infrared (ATR-FTIR) spectroscopy has been shown to provide a potentially straightforward, reagent-free method for the identification of a range of disease-related biomarkers and is in current clinical use for analyses of the chemical composition of kidney stones. We assessed the feasibility of ATR-FTIR spectroscopy as an alternative method to measure salivary urea in patients with different stages of CKD. The ATR-FTIR spectra of dried saliva samples from six healthy controls and 20 patients with CKD (stages 1-5) were analyzed to provide their urea concentrations. The lower limit of detection of salivary urea by the ATR-FTIR spectroscopy method was 1-2 mM, at the lower end of the clinically relevant range. Statistically significant differences in salivary urea concentrations were demonstrated between healthy subjects (4.1±0.5 mM) and patients with CKD stages 3-5 (CKD stage 3, 6.8±0.7 mM; CKD stage 4, 9.1±1 mM; CKD stage 5, 14.8±1.6 mM). These salivary urea concentrations correlated well with serum urea levels in the same patients measured by an automated analyzer (Spearman rank correlation coefficient of 0.71; P<0.001). The ability of the method to detect and stage CKD was assessed from the sensitivity and specificity parameters of a receiver operating characteristics (ROC) curve analysis. This proof-of-concept study demonstrates that quantitation of salivary urea by ATR-FTIR spectroscopy could provide a viable tool for rapid and cost-effective diagnosis of stages 3-5 CKD.
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Affiliation(s)
- Tzu-Ling Lin
- Division of Medicine, Department of Renal Medicine, Royal Free Campus, University College London, London, United Kingdom
| | - Rhys D.R. Evans
- Division of Medicine, Department of Renal Medicine, Royal Free Campus, University College London, London, United Kingdom
| | - Robert J. Unwin
- Division of Medicine, Department of Renal Medicine, Royal Free Campus, University College London, London, United Kingdom
| | - Jill T. Norman
- Division of Medicine, Department of Renal Medicine, Royal Free Campus, University College London, London, United Kingdom
| | - Peter R. Rich
- Glynn Laboratory of Bioenergetics, Department of Structural and Molecular Biology, University College London, London, United Kingdom
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Evans RDR, Hemmila U, Mzinganjira H, Mtekateka M, Banda E, Sibale N, Kawale Z, Phiri C, Dreyer G, Calice-Silva V, Raimann JG, Levin N, Pecoits-Filho R, Mehta R, Macedo E. Diagnostic performance of a point-of-care saliva urea nitrogen dipstick to screen for kidney disease in low-resource settings where serum creatinine is unavailable. BMJ Glob Health 2021; 5:bmjgh-2020-002312. [PMID: 32371573 PMCID: PMC7228485 DOI: 10.1136/bmjgh-2020-002312] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 03/11/2020] [Accepted: 04/07/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Kidney disease is prevalent in low-resource settings worldwide, but tests for its diagnosis are often unavailable. The saliva urea nitrogen (SUN) dipstick is a laboratory and electricity independent tool, which may be used for the detection of kidney disease. We investigated the feasibility and performance of its use in diagnosing kidney disease in community settings in Africa. METHODS Adult patients at increased risk of kidney disease presenting to three community health centres, a rural district hospital and a central hospital in Malawi were recruited between October 2016 and September 2017. Patients underwent concurrent SUN and creatinine testing at enrolment, and at 1 week, 1 month, 3 months and 6 months thereafter. RESULTS Of 710 patients who presented at increased risk of kidney disease, 655 (92.3%) underwent SUN testing at enrolment, and were included (aged 38 (29-52) years, 367 (56%) female and 333 (50.8%) with HIV). Kidney disease was present in 482 (73.6%) patients and 1479 SUN measurements were made overall. Estimated glomerular filtration rate (eGFR) correlated with SUN (r=-0.39; p<0.0001). The area under the receiver operating characteristics curve was 0.61 for presenting SUN to detect acute or chronic kidney disease, and 0.87 to detect severe (eGFR <15 mL/min/1.73 m2) kidney disease (p<0.0001; sensitivity 82.3%, specificity 81.8%, test accuracy 81.8%). In-hospital mortality was greater if enrolment SUN was elevated (>test pad #1) compared with patients with non-elevated SUN (p<0.0001; HR 3.3 (95% CI 1.7 to 6.1). CONCLUSIONS SUN, measured by dipstick, is feasible and may be used to screen for kidney disease in low resource settings where creatinine tests are unavailable.
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Affiliation(s)
| | - Ulla Hemmila
- Renal Medicine, Barts Health NHS Trust, London, London, UK
| | - Henry Mzinganjira
- Renal Medicine, Queen Elizabeth Central Hospital, Blantyre, Southern Region, Malawi
| | - Mwayi Mtekateka
- Renal Medicine, Queen Elizabeth Central Hospital, Blantyre, Southern Region, Malawi
| | - Enos Banda
- Renal Medicine, Queen Elizabeth Central Hospital, Blantyre, Southern Region, Malawi
| | - Naomi Sibale
- Renal Medicine, Queen Elizabeth Central Hospital, Blantyre, Southern Region, Malawi
| | - Zuze Kawale
- Renal Medicine, Queen Elizabeth Central Hospital, Blantyre, Southern Region, Malawi
| | - Chimota Phiri
- Renal Medicine, Queen Elizabeth Central Hospital, Blantyre, Southern Region, Malawi
| | - Gavin Dreyer
- Renal Medicine, Barts Health NHS Trust, London, London, UK
| | - Viviane Calice-Silva
- Renal Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brazil
| | | | - Nathan Levin
- Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - Ravi Mehta
- Medicine, University of California San Diego, La Jolla, California, USA
| | - Etienne Macedo
- Medicine, University of California San Diego, La Jolla, California, USA
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Association of Salivary Statherin, Calcium, and Proline-Rich Proteins on Oral Hygiene: A Cross-Sectional Study. Int J Dent 2021; 2021:1982083. [PMID: 33688346 PMCID: PMC7925028 DOI: 10.1155/2021/1982083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 02/08/2021] [Accepted: 02/17/2021] [Indexed: 11/18/2022] Open
Abstract
Background Saliva, as a complex biofluid, plays a pivotal role in maintaining oral health and tooth integrity. There has been inconsistent data available on the relationship between salivary parameters and oral health. This study aims to investigate the association between salivary statherin, acidic proline-rich proteins (aPRP), and calcium with oral hygiene status. Methods One hundred and eighty-eight healthy subjects aged between 18 and 50 years with varying oral hygiene status who gave consent to participate were included in this cross-sectional study. The subjects were recruited from primary oral health care of MAHSA University. Oral hygiene of all the participants was measured using Oral Hygiene Index–Simplified (OHI-S). Stimulated saliva collected using paraffin wax was analyzed for salivary statherin, aPRP, and calcium. The relationship between salivary statherin, aPRP, and calcium levels with OHI-S was assessed using Spearman's Rank correlation coefficient; the strength of relationship was assessed by multiple linear regression analysis. Results The study found a weak positive correlation (r = 0.179, p = 0.014) between salivary statherin and OHI-S; weak negative correlation (r = −0.187, p = 0.010) between salivary aPRP and OHI-S; and moderate negative correlation between salivary statherin and salivary aPRP levels (r = −0.50, p < 0.001) which were statistically significant. Conclusion Poor oral hygiene is associated with increased statherin and reduced aPRP levels in saliva. Thus, these salivary components may have a role in predicting oral hygiene status.
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Rodrigues RPCB, Vieira WDA, Siqueira WL, Agostini BA, Moffa EB, Paranhos LR. Saliva as a tool for monitoring hemodialysis: a systematic review and meta-analysis. Braz Oral Res 2020; 35:e016. [PMID: 33331408 DOI: 10.1590/1807-3107bor-2021.vol35.0016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 09/01/2020] [Indexed: 11/22/2022] Open
Abstract
This study aimed to assess whether the reductions in serum urea and creatinine levels are different from the reductions in salivary urea and creatinine levels that occur after hemodialysis in chronic renal patients. The systematic review protocol was registered in the PROSPERO database. Eight databases were searched to identify pretest-posttest studies of chronic kidney disease patients undergoing hemodialysis, with no language or year restrictions. The JBI Critical Appraisal Tool was used to assess the risk of bias. Meta-analyses using random-effect models were conducted to compare salivary and serum correlations and to pooled mean and proportion differences from pre- to posthemodialysis urea and creatinine levels by subgroup analysis. The I2 test was used to assess heterogeneity, and a meta-regression was performed to statistically assess correlations and differences in the pooled effects pre- and postdialysis. The Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) was used to assess the certainty of evidence. The search resulted in 1404 records, and only six studies (n = 252 participants) fulfilled the eligibility criteria and were included. The studies were published between 2013 and 2018. All studies showed a significant reduction in both salivary and serum urea/creatinine levels. All eligible studies presented a low risk of bias. The meta-analysis shows a moderate to high correlation between salivary and blood levels of urea (r: 0.79; 95% CI: 0.56-1.00) and creatinine (r: 0.64; 95%CI: 0.16-1.00), with a very low level of certainty. The reductions in salivary urea and creatinine levels are similar to and correlated with the reductions in blood urea and creatine levels after hemodialysis among chronic kidney disease patients.
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Affiliation(s)
| | - Walbert de Andrade Vieira
- Universidade Estadual de Campinas - Unicamp, School of Dentistry of Piracicaba, Department of Restorative Dentistry, Endodontics Division, Piracicaba, SP, Brazil
| | | | | | - Eduardo Buozi Moffa
- Centro Universitário das Faculdades Associadas - Unifae, Department of Dentistry, São João da Boa Vista, SP, Brazil
| | - Luiz Renato Paranhos
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Preventive and Community Dentistry, Uberlândia, MG, Brazil
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Rodrigues RPCB, de Andrade Vieira W, Siqueira WL, Blumenberg C, de Macedo Bernardino Í, Cardoso SV, Flores-Mir C, Paranhos LR. Saliva as an alternative to blood in the determination of uremic state in adult patients with chronic kidney disease: a systematic review and meta-analysis. Clin Oral Investig 2020; 24:2203-2217. [PMID: 32447524 DOI: 10.1007/s00784-020-03340-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 05/11/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To assess whether salivary urea and creatinine levels accurately reflect their serum levels in blood samples of adults to detect chronic kidney disease. MATERIALS AND METHODS A systematic review was conducted in eight electronic databases. The protocol was registered in PROSPERO. Only diagnostic test studies were included. The JBI critical appraisal tools assessed the risk of bias. A meta-analysis of proportions was performed. The GRADE tool assessed the quality of evidence and strength of recommendation across the studies included. RESULTS Eight studies met the eligibility criteria and were included. Six studies assessed salivary urea, and six studies assessed salivary creatinine. All studies presented moderate risk of bias. The meta-analysis depicted an overall sensitivity of 93.3% (95% CI = 88.6; 97.9) for salivary creatinine levels and 87.5% (95% CI = 83.2; 91.8) for salivary urea levels, while the overall specificity was 87.1% (95% CI = 82.8; 91.3) and 83.2% (95% CI = 65.0; 101.4) for salivary creatinine and urea levels, respectively. The overall accuracy of salivary creatinine was 5.2 percentage points higher compared with salivary urea levels (90.8% vs. 85.6%). According to the GRADE tool, the analysed outcomes were classified as having low to moderate level of certainty. CONCLUSION Compared with blood samples, salivary urea and creatinine levels presented high diagnostic values for chronic kidney disease screening, but should not be considered equivalent to levels obtained from blood at stages three, four, or five of the disease. CLINICAL SIGNIFICANCE Chronic kidney disease patients could receive a clinically significant benefit from replacing blood with saliva for potentially monitoring renal function. Saliva collection presents greater simplicity, comfort, safety, and lower collection cost.
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Affiliation(s)
| | - Walbert de Andrade Vieira
- Department of Restorative Dentistry, Endodontics Division, School of Dentistry of Piracicaba, State University of Campinas, UNICAMP, Piracicaba, Brazil
| | | | - Cauane Blumenberg
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | | | - Sérgio Vitorino Cardoso
- Division of Pathology, School of Dentistry, Federal University of Uberlândia, Uberlândia, Brazil
| | - Carlos Flores-Mir
- Division of Orthodontics, School of Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Luiz Renato Paranhos
- Division of Preventive and Community Dentistry, School of Dentistry, Federal University of Uberlândia, Uberlândia, Brazil.
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Nogueira FN, Romero AC, Pedrosa MDS, Ibuki FK, Bergamaschi CT. Oxidative stress and the antioxidant system in salivary glands of rats with experimental chronic kidney disease. Arch Oral Biol 2020; 113:104709. [PMID: 32222491 DOI: 10.1016/j.archoralbio.2020.104709] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/06/2020] [Accepted: 03/11/2020] [Indexed: 01/18/2023]
Abstract
OBJECTIVE This study aims to analyze the presence of oxidative stress and activity of the antioxidant system in the parotid and submandibular salivary glands of rats with Chronic Kidney Disease (CKD). DESIGN Sixteen male wistar rats were divided into two groups (n = 8, each): control rats and rats with CKD. CKD was induced by 5/6 nephrectomy. Blood urea nitrogen and serum creatinine clearance were quantified. Malondialdehyde, superoxide dismutase, glutathione peroxidase, glutathione reductase, catalase, total antioxidant status, ascorbic acid, α-tocopherol, superoxide anion, and hydrogen peroxide concentrations were assessed. RESULTS In CKD rats, blood urea nitrogen, serum creatinine, and proteinuria concentrations were increased, while creatinine clearance was reduced. In the submandibular gland, superoxide anion concentration was increased significantly (p < 0.05). Hydrogen peroxide and superoxide anion concentrations were reduced in the parotid gland. CKD rats presented increased malondialdehyde concentration, total antioxidant status, superoxide dismutase, and glutathione reductase activities only in the parotid gland (p < 0.05). CONCLUSION Oxidative stress and changes in the antioxidant system were found in the parotid and submandibular salivary glands in an experimental model of CKD induced by 5/6 nephrectomy.
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Affiliation(s)
- Fernando Neves Nogueira
- Department of Biomaterials and Oral Biology, Faculdade de Odontologia, Universidade de São Paulo (USP), Brazil.
| | - Ana Carolina Romero
- Department of Biomaterials and Oral Biology, Faculdade de Odontologia, Universidade de São Paulo (USP), Brazil
| | - Marlus da Silva Pedrosa
- Department of Biomaterials and Oral Biology, Faculdade de Odontologia, Universidade de São Paulo (USP), Brazil
| | - Flavia Kazue Ibuki
- Department of Biomaterials and Oral Biology, Faculdade de Odontologia, Universidade de São Paulo (USP), Brazil
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Wang KH, Hsieh JC, Chen CC, Zan HW, Meng HF, Kuo SY, Nguyễn MTN. A low-cost, portable and easy-operated salivary urea sensor for point-of-care application. Biosens Bioelectron 2019; 132:352-359. [DOI: 10.1016/j.bios.2019.03.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 03/05/2019] [Accepted: 03/06/2019] [Indexed: 01/31/2023]
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Clingan H, Rusk D, Smith K, Garcia AA. Viscous Fingering of Miscible Liquids in Porous and Swellable Media for Rapid Diagnostic Tests. Bioengineering (Basel) 2018; 5:E94. [PMID: 30380627 PMCID: PMC6315716 DOI: 10.3390/bioengineering5040094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Revised: 10/22/2018] [Accepted: 10/23/2018] [Indexed: 11/16/2022] Open
Abstract
In lateral flow and colorimetric test strip diagnostics, the effects of capillary action and diffusion on speed and sensitivity have been well studied. However, another form of fluid motion can be generated due to stresses and instabilities generated in pores when two miscible liquids with different densities and viscosities come into contact. This study explored how a swellable test pad can be deployed for measuring urea in saliva by partially prefilling the pad with a miscible solution of greater viscosity and density. The resultant Korteweg stresses and viscous fingering patterns were analyzed using solutions with added food color through video analysis and image processing. Image analysis was simplified using the saturation channel after converting RGB image sequences to HSB. The kinetics of liquid mixing agreed with capillary displacement results for miscible liquids undergoing movement from Korteweg stresses. After capillary filling, there was significant movement of liquid due to these fluidic effects, which led to mixing of the saliva sample with an enzyme test solution. Owing to the simplicity and speed of this test method, urea can be analyzed with an electronic nose over a useful range for detecting salivary urea concentration for rapid and early detection of dehydration.
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Affiliation(s)
- Holly Clingan
- School of Molecular Sciences, Arizona State University, Tempe, AZ 85287, USA.
| | - Devon Rusk
- School of Biological & Health Systems Engineering, Arizona State University, Tempe, AZ 85287, USA.
| | - Kathryn Smith
- School of Biological & Health Systems Engineering, Arizona State University, Tempe, AZ 85287, USA.
| | - Antonio A Garcia
- School of Biological & Health Systems Engineering, Arizona State University, Tempe, AZ 85287, USA.
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Tvarijonaviciute A, Pardo-Marin L, Tecles F, Carrillo JD, Garcia-Martinez JD, Bernal L, Pastor J, Cerón JJ, Martinez-Subiela S. Measurement of urea and creatinine in saliva of dogs: a pilot study. BMC Vet Res 2018; 14:223. [PMID: 30029662 PMCID: PMC6053741 DOI: 10.1186/s12917-018-1546-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Accepted: 06/26/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Urea and creatinine in saliva have been reported to be possible markers of chronic kidney disease (CKD) in humans. The aim of this study was to assess if urea and creatinine could be measured in canine saliva, and to evaluate their possible changes in situations of CKD. RESULTS The spectrophotometric assays for urea and creatinine measurements in saliva of dogs showed intra- and inter-assay imprecision lower than 12% and coefficients of correlation close to 1 in linearity under dilution tests. Healthy dogs showed median salivary concentrations of urea of 39.6 mg/dL and creatinine of 0.30 mg/dL, whereas dogs with CKD showed median salivary urea of 270.1 mg/dL and creatinine of 1.86 mg/dL. Positive high correlations were found between saliva and serum activities of the two analytes (urea, r = 0.909; P < 0.001; creatinine, r = 0.819; P < 0.001). CONCLUSIONS Urea and creatinine concentrations can be measured in canine saliva with commercially available spectrophotometric assays. Both analytes showed higher values in saliva of dogs with CKD compared with healthy dogs and their values were highly correlated with those in serum in our study conditions.
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Affiliation(s)
- Asta Tvarijonaviciute
- From the Interdisciplinary Laboratory of Clinical Analysis (Interlab-UMU), Regional Campus of International Excellence “Campus Mare Nostrum”, University of Murcia, Campus of Espinardo s/n, 30100 Murcia, Spain
| | - Luis Pardo-Marin
- From the Interdisciplinary Laboratory of Clinical Analysis (Interlab-UMU), Regional Campus of International Excellence “Campus Mare Nostrum”, University of Murcia, Campus of Espinardo s/n, 30100 Murcia, Spain
| | - Fernando Tecles
- From the Interdisciplinary Laboratory of Clinical Analysis (Interlab-UMU), Regional Campus of International Excellence “Campus Mare Nostrum”, University of Murcia, Campus of Espinardo s/n, 30100 Murcia, Spain
| | - Juana Dolores Carrillo
- From the Department of Animal Medicine and Surgery, School of Veterinary Medicine, University of Murcia, Murcia, Spain
| | - Juan Diego Garcia-Martinez
- From the Interdisciplinary Laboratory of Clinical Analysis (Interlab-UMU), Regional Campus of International Excellence “Campus Mare Nostrum”, University of Murcia, Campus of Espinardo s/n, 30100 Murcia, Spain
| | - Luis Bernal
- From the Interdisciplinary Laboratory of Clinical Analysis (Interlab-UMU), Regional Campus of International Excellence “Campus Mare Nostrum”, University of Murcia, Campus of Espinardo s/n, 30100 Murcia, Spain
| | - Josep Pastor
- From the Animal Medicine and Surgery Department, School of Veterinary Medicine, University Autonomous of Barcelona, Barcelona, Spain
| | - José J. Cerón
- From the Interdisciplinary Laboratory of Clinical Analysis (Interlab-UMU), Regional Campus of International Excellence “Campus Mare Nostrum”, University of Murcia, Campus of Espinardo s/n, 30100 Murcia, Spain
| | - Silvia Martinez-Subiela
- From the Interdisciplinary Laboratory of Clinical Analysis (Interlab-UMU), Regional Campus of International Excellence “Campus Mare Nostrum”, University of Murcia, Campus of Espinardo s/n, 30100 Murcia, Spain
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Kovalčíková A, Janšáková K, Gyurászová M, Podracká Ľ, Šebeková K, Celec P, Tóthová Ľ. Salivary creatinine and urea are higher in an experimental model of acute but not chronic renal disease. PLoS One 2018; 13:e0200391. [PMID: 29979784 PMCID: PMC6034877 DOI: 10.1371/journal.pone.0200391] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 06/24/2018] [Indexed: 12/12/2022] Open
Abstract
Plasma creatinine and urea are commonly used markers of kidney function in both acute and chronic renal failure. The needed repeated blood collection is associated with pain, stress and might lead to infections. Saliva has the potential to be a non-invasive alternative diagnostic fluid. The use of saliva in clinical practice is limited, since many factors affect the concentration of salivary biomarkers. The aim of our study was to analyze salivary creatinine and urea in the animal models of acute and chronic renal disease. Bilateral nephrectomy and adenine nephropathy were induced in adult male mice. Both, plasma creatinine and urea were higher in animals with renal failure compared to controls. Salivary creatinine was higher by 81% and salivary urea by 43% in comparison to the control group, but only in animals with bilateral nephrectomy and not in adenine nephropathy. Our results indicate that the increase of salivary creatinine and urea depends on the experimental model of renal failure and its severity. Further studies are needed to monitor the dynamics of salivary markers of renal function and to reveal determinants of their variability.
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Affiliation(s)
- Alexandra Kovalčíková
- Institute of Molecular Biomedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Katarína Janšáková
- Institute of Molecular Biomedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Marianna Gyurászová
- Institute of Molecular Biomedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Ľudmila Podracká
- 1st Department of Pediatrics, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Katarína Šebeková
- Institute of Molecular Biomedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Peter Celec
- Institute of Molecular Biomedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia
- Institute of Pathophysiology, Faculty of Medicine, Comenius University, Bratislava, Slovakia
- Department of Molecular Biology, Faculty of Natural Sciences, Comenius University, Bratislava, Slovakia
| | - Ľubomíra Tóthová
- Institute of Molecular Biomedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia
- * E-mail:
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12
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Gawron-Skarbek A, Prymont-Przymińska A, Sobczak A, Guligowska A, Kostka T, Nowak D, Szatko F. A comparison of native and non-urate Total Antioxidant Capacity of fasting plasma and saliva among middle-aged and older subjects. Redox Rep 2017; 23:57-62. [PMID: 29088986 PMCID: PMC6748680 DOI: 10.1080/13510002.2017.1392714] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES As plasma and salivary total antioxidant capacity (TAC) is mainly contributed by uric acid (UA), the present study measures non-urate TAC (Nu-TAC). The aim of the study was to correlate plasma native TAC, Nu-TAC and UA with their salivary analogues, and compare the UA contribution in both body fluids using two different methods. METHODS The study involved 55 middle-aged and older subjects (66.7 ± 4.5 years). TAC was determined simultaneously with two methods (ferric reducing ability of plasma - FRAP, 2.2-diphenyl-1-picryl-hydrazyl - DPPH and countertypes for saliva - FRAS and DPPHS test), with and without UA (native TAC and Nu-TAC, respectively). Plasma UA and salivary UA (SUA) were assessed. RESULTS Subjects with increased FRAP, DPPH and UA had higher FRAS, DPPHS and SUA, respectively (P < 0.05). Plasma Nu-TAC indices did not correlate with salivary Nu-TAC. The contribution of UA to the plasma and salivary DPPH tests was similar: 75.7 ± 10.3% and 75.2 ± 14.0%, respectively. However, the contribution of UA to FRAS was higher than that for FRAP (71.6 ± 13.9% vs. 64.0 ± 8.1%; P < 0.001). DISCUSSION Our findings suggest that saliva is a good predictor for native plasma TAC but not for Nu-TAC. UA level is comparably dominant in saliva and in plasma according to DPPH, but lower in plasma according to FRAP.
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Affiliation(s)
- Anna Gawron-Skarbek
- a Department of Hygiene and Health Promotion , Medical University of Lodz , Lodz , Poland
| | | | - Agnieszka Sobczak
- c Faculty of Medical Laboratory , Medical University of Lodz , Lodz , Poland
| | | | - Tomasz Kostka
- d Department of Geriatrics , Medical University of Lodz , Lodz , Poland
| | - Dariusz Nowak
- e Department of Clinical Physiology , Medical University of Lodz , Lodz , Poland
| | - Franciszek Szatko
- a Department of Hygiene and Health Promotion , Medical University of Lodz , Lodz , Poland
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Evans RDR, Cooke W, Hemmila U, Calice-Silva V, Raimann J, Craik A, Mandula C, Mvula P, Msusa A, Dreyer G, Levin NW, Pecoits-Filho R. A Salivary Urea Nitrogen Dipstick to Detect Obstetric-Related Acute Kidney Disease in Malawi. Kidney Int Rep 2017; 3:178-184. [PMID: 29340329 PMCID: PMC5762969 DOI: 10.1016/j.ekir.2017.10.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 09/24/2017] [Accepted: 10/02/2017] [Indexed: 02/02/2023] Open
Abstract
Introduction Obstetric-related acute kidney injury (AKI) is associated with adverse outcomes for mother and fetus, particularly in low-income countries. However, laboratory-independent tools to facilitate diagnosis are lacking. We assessed the diagnostic performance of a salivary urea nitrogen (SUN) dipstick to detect obstetric-related acute kidney disease in Malawi. Methods Women at high risk for AKI admitted to an obstetric unit in Blantyre, Malawi, were recruited between 21 September and 11 December 2015. Patients underwent serum creatinine (SCr) testing alongside measurement of SUN using a dipstick on admission, and every 48 hours thereafter if evidence of kidney disease was found. Results A total of 301 patients were included (mean age 25.9 years, 11% HIV positive). Of the patients, 23 (7.6%) had AKI, stage 1 in 47.8%, most commonly due to preeclampsia/eclampsia. Mean presenting SCr values were 108.8 ± 21.8 μmol/l (1.23 ± 0.25 mg/dl), 118 ± 34.45 μmol/l (1.33 ± 0.39 mg/dl), and 136.1 ± 30.4 μmol/l (1.54 ± 0.34 mg/dl) in AKI stages 1 to 3 respectively. SUN > 14 mg/dl had a sensitivity of 12.82% and a specificity of 97.33% to detect acute kidney disease; the area under the receiver operating characteristic curve was 0.551. In patients with normal SUN on admission, perinatal mortality was 11.8%, and was 25.0% if SUN was > 14 mg/dl (P = 0.18). Conclusion The SUN dipstick was specific but insensitive when used to diagnose obstetric-related AKI. Limited biochemical derangement and low salivary urea concentrations due to physiological changes in pregnancy, as opposed to a technical limitation of the dipstick itself, are the likely reason for the lack of sensitivity in this study.
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Affiliation(s)
- Rhys D R Evans
- University of Malawi College of Medicine, Malawi.,University College London Centre for Nephrology, London, UK.,Renal Department, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - William Cooke
- Renal Department, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - Ulla Hemmila
- University of Malawi College of Medicine, Malawi.,Renal Department, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - Viviane Calice-Silva
- School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil.,Pró-rim Foundation, Joinville, Brazil
| | | | - Alison Craik
- Renal Department, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - Chimwemwe Mandula
- Renal Department, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - Priscilla Mvula
- Obstetric Department, Queen Elizabeth Central Hospital, Malawi
| | - Ausbert Msusa
- University of Malawi College of Medicine, Malawi.,Obstetric Department, Queen Elizabeth Central Hospital, Malawi
| | - Gavin Dreyer
- Renal Department, Queen Elizabeth Central Hospital, Blantyre, Malawi.,Bart's Health, London, UK
| | - Nathan W Levin
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
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14
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Pandya D, Nagrajappa AK, Ravi KS. Assessment and Correlation of Urea and Creatinine Levels in Saliva and Serum of Patients with Chronic Kidney Disease, Diabetes and Hypertension- A Research Study. J Clin Diagn Res 2016; 10:ZC58-ZC62. [PMID: 27891460 DOI: 10.7860/jcdr/2016/20294.8651] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 07/05/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Serum urea and creatinine are most widely accepted parameters to assess Chronic Kidney Disease (CKD)status as well as to assess renal status in susceptible diabetic and hypertensive subjects. AIM To assess and correlate the serum and salivary urea and creatinine levels of CKD, diabetes mellitus and hypertensive subjects. MATERIALS AND METHODS This cross-sectional study was done on 120 subjects involving 30 CKD, 30 diabetic, 30 hypertensive subjects and 30 healthy controls. After collection of saliva and blood samples, urea was analyzed by enzymatic calorimetric method and creatinine by Jaffe's method. Kruskal Wallis test and Mann Whitney U test were used for comparison between different groups and correlations between serum and salivary parameters were evaluated by applying Spearman's correlation test. The p-value <0.05 was considered statistically significant. RESULTS The median serum and salivary urea and creatinine levels were highest in CKD group followed by diabetic, hypertensive groups and controls. The correlation coefficient for serum urea and salivary urea was 0.977 and for serum creatinine and salivary creatinine was 0.976, with p-value <0.001. CONCLUSION This study showed that there is a significant positive relationship between salivary and serum urea and creatinine. Thus, salivary urea and creatinine levels can be used non-invasively to detect serum urea and creatinine levels respectively in renal disease and diabetic and hypertensive nephropathic cases.
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Affiliation(s)
- Divya Pandya
- Postgraduate Student, Department of Oral Medicine and Radiology, Hitkarini Dental College and Hospital , Jabalpur, Madhya Pradesh, India
| | - Anil Kumar Nagrajappa
- Professor and HOD, Department of Oral Medicine and Radiology, Hitkarini Dental College and Hospital , Jabalpur, Madhya Pradesh, India
| | - K S Ravi
- Assistant Professor, Department of Preventive and Pediatric Dentisty, King Khalid University , Saudi Arabia
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15
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Chen W, Laiho S, Vaittinen O, Halonen L, Ortiz F, Forsblom C, Groop PH, Lehto M, Metsälä M. Biochemical pathways of breath ammonia (NH
3
) generation in patients with end-stage renal disease undergoing hemodialysis. J Breath Res 2016; 10:036011. [DOI: 10.1088/1752-7155/10/3/036011] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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16
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Bayrakli I, Turkmen A, Akman H, Sezer MT, Kutluhan S. Applications of external cavity diode laser-based technique to noninvasive clinical diagnosis using expired breath ammonia analysis: chronic kidney disease, epilepsy. JOURNAL OF BIOMEDICAL OPTICS 2016; 21:87004. [PMID: 27533447 DOI: 10.1117/1.jbo.21.8.087004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Accepted: 07/25/2016] [Indexed: 06/06/2023]
Abstract
An external cavity laser (ECL)-based off-axis cavity-enhanced absorption spectroscopy was applied to noninvasive clinical diagnosis using expired breath ammonia analysis: (1) the correlation between breath ammonia levels and blood parameters related to chronic kidney disease (CKD) was investigated and (2) the relationship between breath ammonia levels and blood concentrations of valproic acid (VAP) was studied. The concentrations of breath ammonia in 15 healthy volunteers, 10 epilepsy patients (before and after taking VAP), and 27 patients with different stages of CKD were examined. The range of breath ammonia levels was 120 to 530 ppb for healthy subjects and 710 to 10,400 ppb for patients with CKD. There was a statistically significant positive correlation between breath ammonia concentrations and urea, blood urea nitrogen, creatinine, or estimated glomerular filtration rate in 27 patients. It was demonstrated that taking VAP gave rise to increasing breath ammonia levels. A statistically significant difference was found between the levels of exhaled ammonia (NH3) in healthy subjects and in patients with epilepsy before and after taking VAP. The results suggest that our breath ammonia measurement system has great potential as an easy, noninvasive, real-time, and continuous monitor of the clinical parameters related to epilepsy and CKD.
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Affiliation(s)
- Ismail Bayrakli
- Suleyman Demirel University, Biomedical Engineering, Bati kampüsü Isparta, Turkey
| | - Aysenur Turkmen
- Suleyman Demirel University, Biomedical Engineering, Bati kampüsü Isparta, Turkey
| | - Hatice Akman
- Suleyman Demirel University, Biomedical Engineering, Bati kampüsü Isparta, Turkey
| | - M Tugrul Sezer
- Suleyman Demirel University, School of Medicine, Department of Nephrology, Dogu kampüsü Isparta, Turkey
| | - Suleyman Kutluhan
- Suleyman Demirel University, School of Medicine, Department of Neurology, Dogu kampüsü, Isparta, Turkey
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17
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Bayrakli I, Turkmen A, Cem Kockar M. Feasibility Study of Using Breath Ammonia Analysis Based on Off-Axis Cavity-Enhanced Absorption Spectroscopy with External Cavity Diode Laser for Noninvasive Real-Time Diagnosis of Helicobacter Pylori. APPLIED SPECTROSCOPY 2016; 70:1269-1277. [PMID: 27296306 DOI: 10.1177/0003702816654052] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 11/26/2015] [Indexed: 06/06/2023]
Abstract
The purpose of this study is to assess the feasibility of using breath ammonia analysis based on off-axis cavity-enhanced absorption spectroscopy (OA-CEAS) with an external-cavity diode laser (ECL) for noninvasive, real-time diagnosis of Helicobacter pylori (HP) infection. Analyses are performed for the breath of 15 healthy volunteers, and eight children and 19 adults with HP infection. The range of ammonia levels for healthy participants is determined to be between 178 and 610 ppb, whereas the ranges for child and adult patients with HP infection are measured to be 457-2470 ppb and 450-2990 ppb, respectively. The ammonia concentrations for patients with HP infection are significantly higher than the concentrations for healthy volunteers. However, no sharp boundary between the ammonia concentrations in the breath of patients with HP infection and healthy volunteers is observed. No correlation between breath ammonia and either body mass index (BMI) or age is found. The reported results suggest that our breath ammonia measurement system has the potential for future use in easy, noninvasive diagnosis of HP infection.
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Affiliation(s)
- Ismail Bayrakli
- Suleyman Demirel University, Biomedical Engineering, Bati kampusu, Isparta, Turkey
| | - Aysenur Turkmen
- Suleyman Demirel University, Biomedical Engineering, Bati kampusu, Isparta, Turkey
| | - Muhammet Cem Kockar
- Suleyman Demirel University, School of Medicine, Dogu kampusu, Isparta, Turkey
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18
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Romero AC, Bergamaschi CT, de Souza DN, Nogueira FN. Salivary Alterations in Rats with Experimental Chronic Kidney Disease. PLoS One 2016; 11:e0148742. [PMID: 26859883 PMCID: PMC4747488 DOI: 10.1371/journal.pone.0148742] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 01/22/2016] [Indexed: 11/19/2022] Open
Abstract
Objective This study aimed to analyze changes in saliva composition and salivary secretion process of rats with chronic kidney disease induced by 5/6 nephrectomy to set the foundation for salivary studies related to CKD. Methods CKD was induced in Wistar rats via 5/6 nephrectomy. Blood and saliva samples were collected from Control, Sham and CKD groups at 8 and 12 weeks after the surgery. Salivation was stimulated via intraperitoneal injections of pilocarpine (1.0 mg/Kg body weight) or isoproterenol (5.0 mg/Kg body weight). Saliva was collected and immediately stored at -80°C until analysis. The salivary flow rate, total protein, amylase and peroxidase activities, and urea concentrations were measured. The blood urea nitrogen (BUN) and serum creatinine concentrations were also evaluated. Results Increases in BUN and serum creatinine concentrations were observed in the CKD groups. Amylase activity was significantly reduced in response to both stimuli in the CKD groups at 8 weeks and increased in the CKD groups at 12 weeks in response to isoproterenol stimulus. The peroxidase activities of the CKD groups were significantly reduced in response to isoproterenol stimulation and were increased at 12 weeks in response to pilocarpine stimulation. Salivary urea was significantly increased in the CKD groups at 8 weeks in response to the isoproterenol stimuli and at 12 weeks in response to both salivary agonists. Conclusions The pattern of alterations observed in this experimental model is similar to those observed in patients and clearly demonstrates the viability of 5/6 nephrectomy as an experimental model in future studies to understand the alterations in salivary compositions and in salivary glands that are elicited by CKD.
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Affiliation(s)
- Ana Carolina Romero
- Departamento de Biomateriais e Biologia Oral, Faculdade de Odontologia, Universidade de São Paulo, São Paulo, Brasil
| | | | - Douglas Nesadal de Souza
- Departamento de Biomateriais e Biologia Oral, Faculdade de Odontologia, Universidade de São Paulo, São Paulo, Brasil
| | - Fernando Neves Nogueira
- Departamento de Biomateriais e Biologia Oral, Faculdade de Odontologia, Universidade de São Paulo, São Paulo, Brasil
- * E-mail:
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19
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Lasisi TJ, Raji YR, Salako BL. Salivary creatinine and urea analysis in patients with chronic kidney disease: a case control study. BMC Nephrol 2016; 17:10. [PMID: 26775026 PMCID: PMC4715295 DOI: 10.1186/s12882-016-0222-x] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 01/08/2016] [Indexed: 11/10/2022] Open
Abstract
Background Many metabolic changes develop in patients with chronic kidney disease which often necessitate frequent biochemical analysis of blood. Saliva analysis as an alternative to blood has many advantages. The aims of this study were to evaluate levels of salivary creatinine and urea in patients with chronic kidney disease in comparison to healthy individuals; to determine correlation between salivary creatinine/urea and blood creatinine/urea and to evaluate the diagnostic potential of saliva. Methods A case control study, involving 50 patients with late stage chronic kidney disease and 49 healthy individuals as control. Blood and saliva samples were analyzed for urea and creatinine levels. Data are presented as median with interquartile range and compared using Independent Samples Mann Whitney U test. Correlation between plasma and salivary creatinine as well as urea was determined using Spearman’s correlation test. Receiver operating characteristics (ROC) analysis was done to determine the diagnostic ability of salivary creatinine and urea and cut-off values were established. Results Median salivary creatinine levels were 2.60 mg/dl and 0.20 mg/dl while median salivary urea levels were 92.00 mg/dl and 20.50 mg/dl in patients with chronic kidney disease and controls respectively. Salivary levels of creatinine and urea were significantly elevated in chronic kidney disease patients (p < 0.001). In addition, there was positive correlation between blood and salivary creatinine as well as urea levels. Total areas under the curve for salivary creatinine and urea were 0.97 and 0.89 respectively. Cut-off values for salivary creatinine and urea were 0.55 mg/dl and 27.50 mg/dl respectively which gave sensitivity and specificity of 94 % and 85 % for creatinine; as well as 86 % and 93 % for urea. Conclusions Findings of this study suggest that analysis of salivary creatinine and urea in patients with chronic kidney disease reflects their levels in blood. Hence, salivary creatinine and urea could be used as diagnostic biomarkers of chronic kidney disease.
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Affiliation(s)
- Taye Jemilat Lasisi
- Department of Physiology, College of Medicine, University of Ibadan/University College Hospital, Ibadan, Nigeria. .,2Department of Oral Pathology, College of Medicine, University of Ibadan/University College Hospital, Ibadan, Nigeria.
| | - Yemi Raheem Raji
- 3Department of Medicine, College of Medicine, University of Ibadan/University College Hospital, Ibadan, Nigeria
| | - Babatunde Lawal Salako
- 3Department of Medicine, College of Medicine, University of Ibadan/University College Hospital, Ibadan, Nigeria
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20
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Celec P, Tóthová Ľ, Šebeková K, Podracká Ľ, Boor P. Salivary markers of kidney function - Potentials and limitations. Clin Chim Acta 2015; 453:28-37. [PMID: 26633856 DOI: 10.1016/j.cca.2015.11.028] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 11/24/2015] [Accepted: 11/25/2015] [Indexed: 01/28/2023]
Abstract
Saliva can be collected non-invasively, repeatedly and without trained personnel. It is a promising diagnostic body fluid with clinical use in endocrinology and dentistry. For decades, it is known that saliva contains also urea, creatinine and other markers of renal function. Clinical studies have shown that the salivary concentrations of these markers could be useful for the assessment of kidney function without the need of blood collection. This article summarizes the clinical and experimental data on the use of saliva as a diagnostic fluid in nephrology and points out the advantages, pitfalls, technical requirements and future perspective for the use of saliva as a novel potential diagnostic biofluid.
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Affiliation(s)
- Peter Celec
- Institute of Molecular Biomedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia; Center for Molecular Medicine, Slovak Academy of Sciences, Bratislava, Slovakia; Institute of Pathophysiology, Faculty of Medicine, Comenius University, Bratislava, Slovakia; Department of Molecular Biology, Faculty of Natural Sciences, Comenius University, Bratislava, Slovakia.
| | - Ľubomíra Tóthová
- Institute of Molecular Biomedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia; Center for Molecular Medicine, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Katarína Šebeková
- Institute of Molecular Biomedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Ľudmila Podracká
- 1st Department of Pediatrics, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Peter Boor
- Institute of Molecular Biomedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia; Institute of Pathology & Department of Nephrology, RWTH Aachen University, Aachen, Germany
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21
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Nunes LAS, Mussavira S, Bindhu OS. Clinical and diagnostic utility of saliva as a non-invasive diagnostic fluid:
a systematic review. Biochem Med (Zagreb) 2015; 25:177-92. [PMID: 26110030 PMCID: PMC4470107 DOI: 10.11613/bm.2015.018] [Citation(s) in RCA: 173] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 05/14/2015] [Indexed: 12/17/2022] Open
Abstract
This systematic review presents the latest trends in salivary research and its applications in health and disease. Among the large number of analytes present in saliva, many are affected by diverse physiological and pathological conditions. Further, the non-invasive, easy and cost-effective collection methods prompt an interest in evaluating its diagnostic or prognostic utility. Accumulating data over the past two decades indicates towards the possible utility of saliva to monitor overall health, diagnose and treat various oral or systemic disorders and drug monitoring. Advances in saliva based systems biology has also contributed towards identification of several biomarkers, development of diverse salivary diagnostic kits and other sensitive analytical techniques. However, its utilization should be carefully evaluated in relation to standardization of pre-analytical and analytical variables, such as collection and storage methods, analyte circadian variation, sample recovery, prevention of sample contamination and analytical procedures. In spite of all these challenges, there is an escalating evolution of knowledge with the use of this biological matrix.
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Affiliation(s)
| | - Sayeeda Mussavira
- Department of Biochemistry, Centre for Post Graduate Studies, Jain University, Bangalore, India
| | - Omana Sukumaran Bindhu
- Department of Biochemistry, Centre for Post Graduate Studies, Jain University, Bangalore, India
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22
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Seethalakshmi C, Koteeswaran D, Chiranjeevi V. Correlation of Serum and Salivary Biochemical Parameters in end Stage Renal Disease Patients Undergoing Hemodialysis in Pre and Post-Dialysis State. J Clin Diagn Res 2014; 8:CC12-4. [PMID: 25653941 PMCID: PMC4316247 DOI: 10.7860/jcdr/2014/10404.5306] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Accepted: 09/17/2014] [Indexed: 11/24/2022]
Abstract
AIM The aim of this study is to compare the salivary urea, creatine, sodium, potassium and phosphate in pre dialysis and post dialysis state in end stage renal disease patients and compare with the serum counterpart. MATERIALS AND METHODS The study group was selected from patients undergoing hemodialysis due renal failure of any cause, who are undergoing dialysis for at least one year duration in a private hospital in Chennai. The total number of subjects was 30. The venous blood was collected from the study group just prior to the dialysis and after the dialysis from the venous catheter which is placed for the purpose of hemodialysis. The collected samples were immediately (within 15 min) submitted to the laboratory for the biochemical examination of urea, creatinine, sodium, potassium and phosphate by an automated biochemical analyser. Unstimulated whole saliva was collected by spitting method from study group both before and after dialysis. The collected samples were immediately submitted to the laboratory for the biochemical examination of urea, creatinine, sodium, potassium and phosphate by an automated biochemical analyser. RESULT The paired t-test analysis was done in pre and post blood urea, creatinine, potassium and phosphate which was significant with a p-value of < 0.0001 and the same analysis was done in salivary urea in pre and post-dialysis state which also gave a significant reduction in the parameters with a p-value of < 0.0001.
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Affiliation(s)
- C. Seethalakshmi
- Lecturer, Department of Oral Medicine and Radiology, Chettinad Dental College and Research Institute, Chennai, India
| | - D. Koteeswaran
- Professor, Department of Oral Medicine and Radiology, Meenakshi Medical College, Chennai, India
| | - V. Chiranjeevi
- Professor and Head, Department of Nephrology, Meenakshi Medical College, Chennai, India
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Abstract
It is known that the oral cavity is a production site for mouth-exhaled NH3. However, the mechanism of NH3 production in the oral cavity has been unclear. Since bacterial urease in the oral cavity has been found to produce ammonia from oral fluid urea, we hypothesize that oral fluid urea is the origin of mouth-exhaled NH3. Our results show that under certain conditions a strong correlation exists between oral fluid urea and oral fluid ammonia (NH4(+)+NH3) (rs = 0.77, p < 0.001). We also observe a strong correlation between oral fluid NH3 and mouth-exhaled NH3 (rs = 0.81, p < 0.001). We conclude that three main factors affect the mouth-exhaled NH3 concentration: urea concentration, urease activity and oral fluid pH. Bacterial urease catalyses the hydrolysis of oral fluid urea to ammonia (NH4(+)+NH3). Oral fluid ammonia (NH4(+)+NH3) and pH determine the concentration of oral fluid NH3, which evaporates from oral fluid into gas phase and turns to mouth-exhaled NH3.
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Affiliation(s)
- W Chen
- Laboratory of Physical Chemistry, Department of Chemistry, PO Box 55 (A. I. Virtasen aukio 1), FI-00014 University of Helsinki, Finland
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24
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Vuletic L, Spalj S, Rogic D, Ruzic L, Alajbeg I. Effect of L-arginine dietary supplementation on salivary urea concentration and pH in physically active individuals. Aust Dent J 2013; 58:491-7. [DOI: 10.1111/adj.12114] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2013] [Indexed: 11/27/2022]
Affiliation(s)
- L Vuletic
- Department of Physiology, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
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25
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Schmidt FM, Vaittinen O, Metsälä M, Lehto M, Forsblom C, Groop PH, Halonen L. Ammonia in breath and emitted from skin. J Breath Res 2013; 7:017109. [PMID: 23445955 DOI: 10.1088/1752-7155/7/1/017109] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Ammonia concentrations in exhaled breath (eNH3) and skin gas of 20 healthy subjects were measured on-line with a commercial cavity ring-down spectrometer and compared to saliva pH and plasma ammonium ion (NH(+)4), urea and creatinine concentrations. Special attention was given to mouth, nose and skin sampling procedures and the accurate quantification of ammonia in humid gas samples. The obtained median concentrations were 688 parts per billion by volume (ppbv) for mouth-eNH3, 34 ppbv for nose-eNH3, and 21 ppbv for both mouth- and nose-eNH3 after an acidic mouth wash (MW). The median ammonia emission rate from the lower forearm was 0.3 ng cm(-2) min(-1). Statistically significant (p < 0.05) correlations between the breath, skin and plasma ammonia/ammonium concentrations were not found. However, mouth-eNH3 strongly (p < 0.001) correlated with saliva pH. This dependence was also observed in detailed measurements of the diurnal variation and the response of eNH3 to the acidic MW. It is concluded that eNH3 as such does not reflect plasma but saliva and airway mucus NH(+)4 concentrations and is affected by saliva and airway mucus pH. After normalization with saliva pH using the Henderson-Hasselbalch equation, mouth-eNH3 correlated with plasma NH(+)4, which points to saliva and plasma NH(+)4 being linked via hydrolysis of salivary urea.
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Affiliation(s)
- F M Schmidt
- Laboratory of Physical Chemistry, Department of Chemistry, University of Helsinki, Finland.
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26
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Peng CH, Xia YC, Wu Y, Zhou ZF, Cheng P, Xiao P. Influencing factors for saliva urea and its application in chronic kidney disease. Clin Biochem 2012; 46:275-7. [PMID: 23122988 DOI: 10.1016/j.clinbiochem.2012.10.029] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2011] [Revised: 09/25/2012] [Accepted: 10/21/2012] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To analyze possible influencing factors on concentration of saliva urea (SaU) and to validate its application in chronic kidney disease(CKD). DESIGN AND METHODS Level of SaU in patients and normal subjects was researched. RESULTS The concentration of SaU did not vary with sampling time and genders, but was related to ages and level of serum urea (U). CONCLUSION SaU concentration is stable and it is useful in application in CKD.
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Affiliation(s)
- Can-hui Peng
- Department of Nephrology, The Second Xiangya Hospital, Central South University, Changsha, 410011, PR China
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