Brunhilda TegomohNKENGFACK1
1Faculty of Health Science, University of Buea,Cameroon.
CaHReF 2018, Yaoundé Congres hall, 08 – 11 January 2019 ,OERF013
Background : The growing interest in saliva bio science has led to its diagnostic utility as a good surrogate of blood especially in Nephrology with recent studies showing that saliva uric acid levels is decreased by dialysis. Whether this can be used to evaluate dialysis adequacy is unknown.
Objectif: To evaluate the performance of saliva uric acid reduction ratio as a measure of dialysis adequacy in end-stage kidney disease patients on maintenance hemodialysis.
Methodology : We conducted a quasi-experimental study at the Hemodialysis unit of the Yaounde General Hospital from January to March 2018.We included consenting patients on maintenance hemodialysis who could provide unstimulated saliva and excluded patients with inflammatory oral pathologies.2ml of unstimulated saliva was collected after a 15mins fast in a sterile plastic cup before and after dialysis,simultaneously we collected 2ml of blood for creatinine,urea and uric acid assays.We tested:the correlation and agreement between pre and post-dialysis saliva and blood uric acid and the diagnostic performance of saliva uric acid reduction ratio.We analyzed data using SPSS v23.0
Results : We included a total of 70 patients (42% females), with a median age of 51 years.The most frequent co-morbid conditions observed were hypertension and diabetes.All post-dialysis blood levels of creatinine, uric acid, urea and saliva uric acid were significantly lower (<0.001) with median reduction ratios of 66.05%, 73.85%, 69.6% and 60% respectively. Saliva uric acid reduction ratio showed a low positive correlation with blood uric acid reduction ratio (r=0.444). There was a consistent underestimation of blood uric acid reduction ratio by Saliva.Saliva uric acid reduction ratio had a good diagnostic performance (AUC of 0.713) in identifying patients with adequate dialysis.
Conclusion/Recommandation: Saliva uric acid reduction ratio has a low positive correlation with blood uric acid reduction ratio. There is a consistent underestimation of blood uric acid reduction ratio by saliva. However, saliva uric acid reduction ratio has a good diagnostic performance in identifying patients with adequate dialysis. We therefore recommend further studies to validate the target saliva uric acid reduction ratio value and its use in low-income settings in identifying patients with adequate dialysis.
Key Words:saliva, uric acid, dialysis adequacy.