Urinary changes of CKDu patients in Girandurukotte and Wilgamuwa, SriLanka

Abstract

Chronic Kidney Disease of uncertain aetiology (CKDu) is a public health problem in several countries in Central America, India and SriLanka. Urine analysis is an informative and noninvasive diagnostic tool for the presence and severity of kidney disease. The purpose of this study is to determine the findings of urine analysis of CKDu patients compared to CKD and healthy control groups. In CKDu group, 119 of biopsy proven, non-dialysis patients and for control groups, endemic healthy, endemic CKD, non-endemic healthy and non-endemic CKD, 79, 82, 85 and 85 respectively were recruited. Random urine samples were collected for urine analysis. Blood was drawn and centrifuged to obtain serum to measure serum creatinine. In CKDu patients, the average level of Serum creatinine, pH and specific gravity were 178.15 ± 122, 5.25 ± 0.5 and 1.023 ± 0.003 respectively. There were not any gender significance in urine PH and specific gravity of CKDu patients. Only 31 CKDu patients (26%) were positive (> 1+) for proteinuria while 4 patients (3%) were positive for glucosuria. Proteinuria of CKDu patients showed a weak positive correlation (r = 0.477, p < 0.05) with serum creatinine and weak negative correlation (r = -0.353, p < 0.05) with the eGFR. Urine samples of CKDu patients had not active deposits, whereas with few granular casts. Urine PH of CKDu patients was significantly decreased with the endemic healthy control (p < 0.05) while specific gravity was significantly decreased with non-endemic CKD patients (p < 0.05) and healthy controls (p < 0.05). According to the odds ratio, urine protein is 4.7 times high for CKDu than non-endemic CKD whiles such significant difference was not seen with the endemic CKD. Proteinuria was not prominent among CKDu patients like in CKD patients in the endemic and non-endemic area. Sediment analysis was not showed significant findings compared to the control groups.