STUDY OF SALIVARY CREATININE AS AN ALTERNATIVE TO SERUM CREATININE IN PATIENTS WITH CHRONIC KIDNEY DISEASE

INTRODUCTION - Chronic Renal Failure is a            progressive decline of the glomerular filtration rate, leading to an increase of serum creatinine and blood urea nitrogen levels. Frequent sampling of blood is mandatory to diagnose and  monitor the progression of the disease. Collection of blood for serum analysis is an invasive procedure which often causes discomfort and anxiety to the patients. Saliva, a multi-constituent biologic fluid secreted by the salivary glands, is the major          contributor of oral health. This study was done to determine the diagnostic ability of saliva as an alternative to serum to estimate creatinine in CKD patients. AIM OF THE STUDY - 1.To estimate serum and salivary creatinine levels among patients with Chronic Kidney Disease 2.To compare and correlate the serum and salivary creatinine levels among CKD cases and to evaluate the role of saliva as a noninvasive alternative to serum for creatinine estimation in CKD patients. MATERIALS AND  METHODS - This case-control study was done by selecting 50 patients with Chronic Kidney Disease (CKD) and 50 age and sex-matched healthy controls. GFR was estimated by   Cockcroft-Gault formula. Blood and whole unstimulated saliva samples were simultaneously obtained from all the patients. The samples were assayed immediately using creatinine estimation kit by Jaffe kinetic reaction. Statistical analysis was done using t-test. Correlation between serum and salivary creatinine was obtained in cases and controls using Pearsons correlation.  RESULTS - Serum as well as salivary creatinine levels were found to be significantly higher in CKD patients than controls   (p value less than 0.001).The correlation between serum and salivary creatinine in controls was not found to be significant, Pearson correlation coefficient, 0.168, whereas in CKD patients a significant positive correlation was found, 0.952.   CONCLUSION - Saliva can be used as a non-invasive    diagnostic tool as an alternative to serum, for estimating creatinine among Chronic Kidney Disease patients.