Abstract

Research Article

Assessment and Correlation of Serum Urea and Creatinine Levels in Normal, Hypertensive, and Diabetic Persons in Auchi, Nigeria

Akpotaire PA and Seriki SA*

Published: 16 August, 2023 | Volume 7 - Issue 1 | Pages: 007-016

Background/Aim: There has been a progressive rise in the incidence and prevalence of End Stage Renal Disease (ESRD). It has also been observed that the most important reasons for a rapid increase in Chronic Kidney Disease (CKD) patients are the rapidly increasing worldwide incidence of diabetes and hypertension. The present study evaluates the effect of diabetes, hypertension, and comorbid state of hypertension and diabetes (hypertensive-diabetic) on renal function using serum creatinine and urea as markers. 
Method: A total number of 120 persons were recruited for the research; 30 controls, 30 hypertensive, 30 diabetic, and 30 hypertensive-diabetic persons. Of the 30 control persons, 18 were females and 12 were males; of the 30 hypertensive subjects, 17 were females and 13 were males; of the 30 diabetics subjects, 20 were females and 10 were males, whereas of the 30 hypertensive-diabetic subjects, 21 were females and 9 were males. In total, there were seventy-six (76) females and 44 males. The respondents were pulled from Central Hospital (Auchi) Diabetic and General Clinic and Auchi Polytechnic Cottage Hospital. Verbal consent was sort and questionnaires were used to extract information regarding biodata and patients’ history of diabetes and hypertension. Height and weight were measured, and blood pressure was determined taken. Blood samples were collected into fluoride oxalate and lithium heparin bottle for the assessment of FBS and (serum urea and creatinine) respectively. 
Results: The mean (±SD) serum creatinine was higher in the hypertensive-diabetic group (2.08 ± 1.06) and declined as follows: diabetic group (1.75 ± 1.01), hypertensive group (1.34 ± 0.96) and control group (0.70 ± 0.14). The mean (±SD) serum urea was also found to be higher in the hypertensive-diabetic group (17.5 ± 9.06) and declined as follows: diabetic group (14.5 ± 6.13), hypertensive group (12.7 ± 6.23) and control group (7.18 ± 5.06). There was a positive correlation between serum creatinine and fasting blood sugar The study also established a positive correlation between serum creatinine and blood pressure but not between serum urea and blood pressure with r values of 0.31 and 0.16 respectively. 
Conclusion: Good control of blood glucose and blood pressure levels reduces the likelihood of the development of renal impairment which is usually associated with both diabetes and hypertension. Co-morbidity of diabetes and hypertension poses a higher risk of developing renal disease than individual problems of diabetes and hypertension. Serum creatinine and serum urea are important biomarkers for renal impairment hence the two should be monitored on a regular basis for diabetic and hypertensive patients and much more frequently for hypertensive-diabetic patients.

Read Full Article HTML DOI: 10.29328/journal.apcr.1001035 Cite this Article Read Full Article PDF

Keywords:

Serum creatinine; Serum urea; Hypertension; Diabetes; Fasting blood sugar; Co-morbidity

References

  1. World Health Organization. World Health Day 2013: Silent Killer, Global Public Health Crisis. WHO Campaigns. 2013a.
  2. Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet. 2005 Jan 15-21;365(9455):217-23. doi: 10.1016/S0140-6736(05)17741-1. PMID: 15652604.
  3. Global burden of disease report. World Health Organisation, Geneva. 2008.
  4. Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012 Dec 15;380(9859):2224-60. doi: 10.1016/S0140-6736(12)61766-8. Erratum in: Lancet. 2013 Apr 13;381(9874):1276. Erratum in: Lancet. 2013 Feb 23;381(9867):628. AlMazroa, Mohammad A [added]; Memish, Ziad A [added]. PMID: 23245609; PMCID: PMC4156511.
  5. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, Jones DW, Materson BJ, Oparil S, Wright JT Jr, Roccella EJ; Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. National Heart, Lung, and Blood Institute; National High Blood Pressure Education Program Coordinating Committee. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003 Dec;42(6):1206-52. doi: 10.1161/01.HYP.0000107251.49515.c2. Epub 2003 Dec 1. PMID: 14656957.
  6. Grundy SM, Benjamin IJ, Burke GL, Chait A, Eckel RH, Howard BV, Mitch W, Smith SC Jr, Sowers JR. Diabetes and cardiovascular disease: a statement for healthcare professionals from the American Heart Association. Circulation. 1999 Sep 7;100(10):1134-46. doi: 10.1161/01.cir.100.10.1134. Erratum in: Circulation 2000 Apr 4;101(13):1629-31. PMID: 10477542.
  7. Epstein M, Sowers JR. Diabetes mellitus and hypertension. Hypertension. 1992 May;19(5):403-18. doi: 10.1161/01.hyp.19.5.403. PMID: 1568757.
  8. Masoumi A, Reed-Gitomer B, Kelleher C, Schrier RW. Potential pharmacological interventions in polycystic kidney disease. Drugs. 2007;67(17):2495-510. doi: 10.2165/00003495-200767170-00004. PMID: 18034588.
  9. Pontremoli R, Viazzi F, Martinoli C, Ravera M, Nicolella C, Berruti V, Leoncini G, Ruello N, Zagami P, Bezante GP, Derchi LE, Deferrari G. Increased renal resistive index in patients with essential hypertension: a marker of target organ damage. Nephrol Dial Transplant. 1999 Feb;14(2):360-5. doi: 10.1093/ndt/14.2.360. PMID: 10069189.
  10. Zhang Q, Davis KJ, Hoffmann D, Vaidya VS, Brown RP, Goering PL. Urinary biomarkers track the progression of nephropathy in hypertensive and obese rats. Biomark Med. 2014;8(1):85-94. doi: 10.2217/bmm.13.106. PMID: 24325231; PMCID: PMC3951143.
  11. Ritz E. Hypertension and kidney disease. Clin Nephrol. 2010 Nov;74 Suppl 1:S39-43. PMID: 20979962.
  12. Coresh J, Wei GL, McQuillan G, Brancati FL, Levey AS, Jones C, Klag MJ. Prevalence of high blood pressure and elevated serum creatinine level in the United States: findings from the third National Health and Nutrition Examination Survey (1988-1994). Arch Intern Med. 2001 May 14;161(9):1207-16. doi: 10.1001/archinte.161.9.1207. PMID: 11343443.
  13. Mendelssohn DC, Barrett BJ, Brownscombe LM, Ethier J, Greenberg DE, Kanani SD, Levin A, Toffelmire EB. Elevated levels of serum creatinine: recommendations for management and referral. CMAJ. 1999 Aug 24;161(4):413-7. PMID: 10478168; PMCID: PMC1230545.
  14. Wannamethee SG, Shaper AG, Perry IJ. Serum creatinine concentration and risk of cardiovascular disease: a possible marker for increased risk of stroke. Stroke. 1997 Mar;28(3):557-63. doi: 10.1161/01.str.28.3.557. PMID: 9056611.
  15. Bamanikar SA, Bamanikar AA, Arora A. Study of serum urea and creatinine in diabetic and non-diabetic patients in a tertiary teaching hospital. Journal of Medical Research. 2016; 2(1):12-15.
  16. Kanwar G, Jain N, Sharma N, Shekhawat M, Ahmed J, Kabra R. Significance of Serum Urea and Creatinine Levels in Type 2 Diabetic Patients. Iosr-Jdms. 2015; 14:65-7.
  17. Bhattacharjya J, Goswami B. Comparative study of serum creatinine level in normal and hypertensive persons. International Journal of Scientific Study. 2016; 4(2):122-124.
  18. Shekhar CY. Elevation of serum creatinine in hypertensive patient. Journal of Noble Medical College. 2016; 5(2):56-59.
  19. Chutani A, Pande S. Correlation of serum creatinine and urea with glycemic index and duration of diabetes in Type 1 and Type 2 diabetes mellitus: A comparative study National Journal of Physiology, Pharmacy, and Pharmacology. 2017; 7:914-919.
  20. Ediale JR, Adugba OA, Ani OC, Chime UP, Uzoigwe J, Agu UF, Okorie P, Chinemerem N, Onyemaechi BA, Paul C. Serum urea, uric acid, and creatinine levels in diabetic mellitus patients attending Jos University Teaching Hospital, North central Nigeria. International Journal of Biosciences. 2017;11: 68-72.
  21. Adler AI, Stevens RJ, Manley SE, Bilous RW, Cull CA, Holman RR; UKPDS GROUP. Development and progression of nephropathy in type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS 64). Kidney Int. 2003 Jan;63(1):225-32. doi: 10.1046/j.1523-1755.2003.00712.x. PMID: 12472787.
  22. Deepa K, Goud MBK, Devi OS, Devaki R, Nayal B, Prabhu A. Serum urea, creatinine in Relation to fasting plasma glucose levels in type 2 diabetics. IJPBS. 2011; 1:279-83.
  23. Iyengar MR, Coleman DW, Butler TM. Phosphocreatinine, a high-energy phosphate in muscle, spontaneously forms phosphocreatine and creatinine under physiological conditions. J Biol Chem. 1985 Jun 25;260(12):7562-7. PMID: 3997888.
  24. Zhou C, Bhinderwala F, Lehman MK, Thomas VC, Chaudhari SS, Yamada KJ, Foster KW, Powers R, Kielian T, Fey PD. Urease is an essential component of the acid response network of Staphylococcus aureus and is required for a persistent murine kidney infection. PLoS Pathog. 2019 Jan 4;15(1):e1007538. doi: 10.1371/journal.ppat.1007538. PMID: 30608981; PMCID: PMC6343930.
  25. Williams B. Insulin resistance: the shape of things to come. Lancet. 1994 Aug 20;344(8921):521-4. doi: 10.1016/s0140-6736(94)91904-6. PMID: 7914619.
  26. Shlomo M, Polonsky KS, Larsen PR, Kronenberg HM. Diabetes Mellitus. Williams textbook of endocrinology, 12th Ed. Philadelphia: Elsevier/Saunders. 2011;1371-1435.
  27. Zimmet P, Alberti KG, Shaw J. Global and societal implications of the diabetes epidemic. Nature. 2001 Dec 13;414(6865):782-7. doi: 10.1038/414782a. PMID: 11742409.
  28. Cheesbrough M. District Laboratory Practice in Tropical Countries. Part 1. Cambridge University Press, U.k. 2004; 333-345.
  29. Harish J, Srinivas HA. Comparative Study of Glucometer and Laboratory Glucose Oxidase Method for Estimation of Blood Glucose Levels in Neonates. Journal of Evolution of Medical and Dental Sciences. 2015; 4:2652-2663.
  30. Ihim AC, Ogbodo EC, Oguaka VN, Ozuruoke DF, Okwara EC, Nwovu AI, Amah UK, Abiodun BE. Effect of short-term exposure to formalin on kidney function tests of students in Nnewi. European.Journal of Biomedical and Pharmaceutical Sciences. 2017; 4(12):51-55.
  31. Ochei J, Kolhatkar J. Medical Laboratory Sciences, Theory and Practice, Sixth Ed. In: Tata McGraw Hill Company Limited. New Delhi. 2007; 182-183.
  32. Schoolwerth AC, Engelgau MM, Hostetter TH, Rufo KH, Chianchiano D, McClellan WM, Warnock DG, Vinicor F. Chronic kidney disease: a public health problem that needs a public health action plan. Prev Chronic Dis. 2006 Apr;3(2):A57. Epub 2006 Mar 15. PMID: 16539798; PMCID: PMC1563984.
  33. Seriki SA. Hypertension and DiabetesRiskInteraction, and Management Target. Journal of Angiology and Circulatory System. 2020; 1:104.
  34. Singh S, Shankar R, Singh GP. Prevalence and Associated Risk Factors of Hypertension: A Cross-Sectional Study in Urban Varanasi. Int J Hypertens. 2017;2017:5491838. doi: 10.1155/2017/5491838. Epub 2017 Dec 3. PMID: 29348933; PMCID: PMC5733954.

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