CORRELATION OF THE SEVERITY OF CHRONIC KIDNEY DISEASE WITH SERUM URIC ACID

• Basharat Azhar Paul,  
• Sandeep Singh,  
• Rajinderjit Singh Ahi,*  
• Umesh Kumar

Abstract

Background: Chronic kidney disease (CKD) is marked by kidney damage or a glomerular filtration rate (GFR) of less than 60 mL/min/1.73 m2 for at least three months, regardless of the underlying etiology. When a variety of renal problems are present, albuminuria defined as an albumin-to-creatinine ratio >30 mg/g in two out of three spot urine samples can serve to determine kidney failure. The estimated global rate of CKD is 13.4%. In India, one of the most widespread illnesses that is not transmissible. CKD has a significant morbidity, mortality rate, and financial impact. Around 5.2 million people in India died from CKD-related causes in 2008 and that number could rise to 7.63 million by 2023. Some Indian states including Puducherry, Andhra Pradesh, Maharashtra and Odisha have been identified as CKD hotspots. Uric acid is a common component because purine nucleotides are biologically broken down into it. Gout and associated diseases including diabetes and the formation of ammonium acid urate kidney stones are all related to high blood levels of uric acid. Serum uric acid is eliminated principally by the kidneys and while there is a compensatory increased removal by the gut in the setting of renal insufficiency, this is not completely effective and serum uric acid increases as the GFR falls with approximately half of the subjects becoming hyperuricemic by the time dialysis is initiated. Objective: The aim of the present study was to assess the serum uric acid in CKD and study the correlation between eGFR (which is a marker of severity of CKD) and serum uric acid in CKD. Materials and Methods: The present study was observational study. The study was conducted over a period of six months on 180 patients. Blood samples were obtained in Becton Dickinson's commercially available red capped tubes vacutainers (BD). After that, blood samples were left undisturbed at room temperature for 15-30 minutes to coagulate. For 5 minutes, the tubes were centrifuged at 3000 rpm. After centrifugation, the sample solution (serum) was transferred to a fresh polypropylene tube with a Pasteur pipette. Serum uric acid and serum creatinine was done on fully automated SYSMEX BX-3010. Results: Our results show that mean and standard deviation of serum uric acid with p value between males and females in the different stages of chronic kidney disease which shows a statistically significant difference between stage II, stage III B and stage IV. p-value was found to be statistically significant (p=0.0042, 0.0004 and 0.0487 respectively). Conclusion: The present study highlights the progressive increase in serum uric acid levels as CKD advances through its stages.

Keywords

CKD,GFR,Uric acid,Creatinine