Background: Many metabolic changes develop in patients with chronic kidney disease which often necessitate\nfrequent biochemical analysis of blood. Saliva analysis as an alternative to blood has many advantages. The aims of\nthis study were to evaluate levels of salivary creatinine and urea in patients with chronic kidney disease in comparison\nto healthy individuals; to determine correlation between salivary creatinine/urea and blood creatinine/urea and to\nevaluate the diagnostic potential of saliva.\nMethods: A case control study, involving 50 patients with late stage chronic kidney disease and 49 healthy individuals\nas control. Blood and saliva samples were analyzed for urea and creatinine levels. Data are presented as median with\ninterquartile range and compared using Independent Samples Mann Whitney U test. Correlation between plasma and\nsalivary creatinine as well as urea was determined using Spearman�s correlation test. Receiver operating characteristics\n(ROC) analysis was done to determine the diagnostic ability of salivary creatinine and urea and cut-off values were\nestablished.\nResults: Median salivary creatinine levels were 2.60 mg/dl and 0.20 mg/dl while median salivary urea levels\nwere 92.00 mg/dl and 20.50 mg/dl in patients with chronic kidney disease and controls respectively. Salivary\nlevels of creatinine and urea were significantly elevated in chronic kidney disease patients (p < 0.001). In addition, there\nwas positive correlation between blood and salivary creatinine as well as urea levels. Total areas under the curve for\nsalivary creatinine and urea were 0.97 and 0.89 respectively. Cut-off values for salivary creatinine and urea were 0.55 mg/dl\nand 27.50 mg/dl respectively which gave sensitivity and specificity of 94 % and 85 % for creatinine; as well as 86 % and\n93 % for urea.\nConclusions: Findings of this study suggest that analysis of salivary creatinine and urea in patients with chronic kidney\ndisease reflects their levels in blood. Hence, salivary creatinine and urea could be used as diagnostic biomarkers of chronic\nkidney disease.
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