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Basilicata M, Pieri M, Marrone G, Nicolai E, Di Lauro M, Paolino V, Tomassetti F, Vivarini I, Bollero P, Bernardini S, Noce A. Saliva as Biomarker for Oral and Chronic Degenerative Non-Communicable Diseases. Metabolites 2023; 13:889. [PMID: 37623833 PMCID: PMC10456419 DOI: 10.3390/metabo13080889] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 08/26/2023] Open
Abstract
Saliva is a very complex fluid and it is essential to maintain several physiological processes and functions, including oral health, taste, digestion and immunological defenses. Saliva composition and the oral microbiome can be influenced by several factors, like diet and smoking habits, and their alteration can represent an important access point for pathogens and, thus, for systemic illness onset. In this review, we explore the potentiality of saliva as a new tool for the early detection of some pathological conditions, such as oral diseases, chronic degenerative non-communicable diseases, among these chronic kidney disease (CKD). We also examined the possible correlation between oral and systemic diseases and oral and gut microbiota dysbiosis. In particular, we deeply analyzed the relationship between oral diseases and CKD. In this context, some salivary parameters can represent a new device to detect either oral or systemic pathologies. Moreover, the positive modulation of oral and gut microbiota induced by prebiotics, postbiotics, or symbiotics could represent a new possible adjuvant therapy in the clinical management of oral diseases and CKD.
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Affiliation(s)
- Michele Basilicata
- UOSD Special Care Dentistry, Policlinico Tor Vergata, 00133 Rome, Italy
- Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Massimo Pieri
- Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, 00133 Rome, Italy
- Department of Laboratory Medicine, “Tor Vergata” University Hospital, Viale Oxford 81, 00133 Rome, Italy
| | - Giulia Marrone
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Eleonora Nicolai
- Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Manuela Di Lauro
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Vincenza Paolino
- UOSD Special Care Dentistry, Policlinico Tor Vergata, 00133 Rome, Italy
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Flaminia Tomassetti
- Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Ilaria Vivarini
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Patrizio Bollero
- UOSD Special Care Dentistry, Policlinico Tor Vergata, 00133 Rome, Italy
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Sergio Bernardini
- Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, 00133 Rome, Italy
- Department of Laboratory Medicine, “Tor Vergata” University Hospital, Viale Oxford 81, 00133 Rome, Italy
| | - Annalisa Noce
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
- UOSD Nephrology and Dialysis, Policlinico Tor Vergata, 00133 Rome, Italy
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Poposki B, Ivanovski K, Stefanova R, Dirjanska K, Rambabova-Bushljetik I, Ristovski V, Risteska N. Salivary Markers in Patients with Chronic Kidney Disease. Pril (Makedon Akad Nauk Umet Odd Med Nauki) 2023; 44:139-147. [PMID: 37453126 DOI: 10.2478/prilozi-2023-0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
Aim of the study: To determine the possibility of using saliva as a diagnostic and prognostic tool for screening and monitoring kidney function. Methods: This study included 32 patients with different stages of chronic kidney disease (CKD) and 20 healthy examinees for the control group. Saliva was collected using the spitting method, and on the same day blood was also drawn from the examinees to determine serum concentrations of urea and creatinine. The salivary values of uric acid, urea, creatinine and albumin were determined with a spectrophotometer, as well as the serum concentrations of urea and creatinine. Results: Our results showed a statistically significant positive correlation between salivary and serum levels of urea and creatinine in patients with CKD (Pearson's correlation coefficient for urea was r =0.6527, p = 0.000, while for creatinine it was r = 0.5486, p = 0.001). We detected a statistically significant positive correlation between the salivary levels of urea and the clinical stage of CKD (r = 0.4667, p = 0.007). We did not register a significant correlation between the salivary levels of creatinine and the clinical stage of CKD (r = 0.1643, p = 0.369). Conclusion : Salivary urea is a valid marker for determining kidney function and a potential salivary marker for screening and monitoring kidney function. Salivary creatinine can be used as a qualitative marker, only indicating the existence of a disease.
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Affiliation(s)
- Bojan Poposki
- 1Department of Oral and Periodontal Diseases, Faculty of Dentistry - Skopje, Ss. Cyril and Methodius University in Skopje, RN Macedonia
| | - Kiro Ivanovski
- 1Department of Oral and Periodontal Diseases, Faculty of Dentistry - Skopje, Ss. Cyril and Methodius University in Skopje, RN Macedonia
| | - Renata Stefanova
- 1Department of Oral and Periodontal Diseases, Faculty of Dentistry - Skopje, Ss. Cyril and Methodius University in Skopje, RN Macedonia
| | - Katarina Dirjanska
- 1Department of Oral and Periodontal Diseases, Faculty of Dentistry - Skopje, Ss. Cyril and Methodius University in Skopje, RN Macedonia
| | | | - Vangel Ristovski
- 3Institute of Medical Physiology and Anthropology, Faculty of Medicine - Skopje, Ss. Cyril and Methodius University in Skopje, RN Macedonia
| | - Nada Risteska
- 4Clinic of Oral and Periodontal Diseases, PHO Dental Clinic Center St. Panteleimon, Skopje, RN Macedonia
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SPR-Based Sensor for the Early Detection or Monitoring of Kidney Problems. Int J Biomater 2022; 2022:9135172. [PMID: 35755268 PMCID: PMC9225913 DOI: 10.1155/2022/9135172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 05/12/2022] [Accepted: 05/19/2022] [Indexed: 11/17/2022] Open
Abstract
SPR-based technology has emerged as one of the most versatile optical tools for analyzing the binding mechanism of molecular interaction due to its inherent advantages in sensing applications, such as real-time, label-free, and high sensitivity characteristics. SPR is widely used in various fields, including healthcare, environmental management, and food-borne illness analysis. Meanwhile, kidney disease has grown to be one of the world's most serious public health problems in recent decades, resulting in physical degeneration and even death. As a result, several studies have published their findings regarding developing of reliable sensor technology based on the SPR phenomenon. However, an integrated and comprehensive discussion regarding the application of SPR-based sensors for detecting of kidney disease has not yet been found. Therefore, this review will discuss the recent advancements in the development of SPR-based sensors for monitoring kidney-related diseases. Numerous SPR configurations will be discussed, including Kretschmann, Otto, optical fiber-based SPR, and LSPR, which are all used to detect analytes associated with kidney disease, including urea, creatinine, glucose, uric acid, and dopamine. This review aims to show the broad application of SPR sensors which encouraged the development of SPR sensors for kidney problems monitoring.
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Ghosh A, Vallam Thodi F, Sengupta S, Kannan S, Krishnan L, Bhattacharya E. Effective clearance of uremic toxins using functionalised silicon Nanoporous membranes. Biomed Microdevices 2021; 23:4. [PMID: 33415531 DOI: 10.1007/s10544-020-00539-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2020] [Indexed: 12/24/2022]
Abstract
In-house fabricated silicon nanoporous membranes (SNMs), functionalized for efficient clearance of uremic toxins, can lead to compact and portable dialysis systems. Efficacy of 15 nm thick SNMs, with average pore diameter of 8 nm, was tested for dialysis of two uremic toxins - urea and creatinine using custom made teflon apparatus of 2, 10 and 30 ml. The apparatus consisted of two reservoirs, with the cis containing the uremic fluid, and the trans containing the dialysate. Peristalsis was found to enhance the clearance rate by a factor of four as compared to unstirred condition. Functionalisation of the SNMs reduced protein binding, and surface binding of urea from 23% to negligible values. A lateral array of nine SNMs and a new design for the dialysis apparatus, increased the clearance rate by a factor of twelve from that of the single SNM. The arrays cleared about 42% of urea and 48% of creatinine from 30 ml of diluted serum samples, in 15 min. Periodic replacement of the trans fluid cleared about 81% of high concentration uremic toxins from the cis reservoir in 45 mins. The SNM arrays are stable, reproducible, and with the superior clearance rates for urea and creatinine, they have the potential to be used as membranes for portable hemodialysers.
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Affiliation(s)
- Ananya Ghosh
- Department of Electrical Engineering, Indian Institute of Technology-Madras, Chennai, 600036, India
| | - Fidal Vallam Thodi
- Centre for NEMS and Nanophotonics, Indian Institute of Technology-Madras, Chennai, 600036, India
| | - Sudeshna Sengupta
- Centre for NEMS and Nanophotonics, Indian Institute of Technology-Madras, Chennai, 600036, India
| | - Sivasundari Kannan
- Department of Electrical Engineering, Indian Institute of Technology-Madras, Chennai, 600036, India
| | - Lalitha Krishnan
- Centre for NEMS and Nanophotonics, Indian Institute of Technology-Madras, Chennai, 600036, India
| | - Enakshi Bhattacharya
- Department of Electrical Engineering, Indian Institute of Technology-Madras, Chennai, 600036, India. .,Centre for NEMS and Nanophotonics, Indian Institute of Technology-Madras, Chennai, 600036, India.
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Rodrigues RPCB, Vieira WDA, Siqueira WL, Agostini BA, Moffa EB, Paranhos LR. Saliva as a tool for monitoring hemodialysis: a systematic review and meta-analysis. Braz Oral Res 2020; 35:e016. [PMID: 33331408 DOI: 10.1590/1807-3107bor-2021.vol35.0016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 09/01/2020] [Indexed: 11/22/2022] Open
Abstract
This study aimed to assess whether the reductions in serum urea and creatinine levels are different from the reductions in salivary urea and creatinine levels that occur after hemodialysis in chronic renal patients. The systematic review protocol was registered in the PROSPERO database. Eight databases were searched to identify pretest-posttest studies of chronic kidney disease patients undergoing hemodialysis, with no language or year restrictions. The JBI Critical Appraisal Tool was used to assess the risk of bias. Meta-analyses using random-effect models were conducted to compare salivary and serum correlations and to pooled mean and proportion differences from pre- to posthemodialysis urea and creatinine levels by subgroup analysis. The I2 test was used to assess heterogeneity, and a meta-regression was performed to statistically assess correlations and differences in the pooled effects pre- and postdialysis. The Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) was used to assess the certainty of evidence. The search resulted in 1404 records, and only six studies (n = 252 participants) fulfilled the eligibility criteria and were included. The studies were published between 2013 and 2018. All studies showed a significant reduction in both salivary and serum urea/creatinine levels. All eligible studies presented a low risk of bias. The meta-analysis shows a moderate to high correlation between salivary and blood levels of urea (r: 0.79; 95% CI: 0.56-1.00) and creatinine (r: 0.64; 95%CI: 0.16-1.00), with a very low level of certainty. The reductions in salivary urea and creatinine levels are similar to and correlated with the reductions in blood urea and creatine levels after hemodialysis among chronic kidney disease patients.
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Affiliation(s)
| | - Walbert de Andrade Vieira
- Universidade Estadual de Campinas - Unicamp, School of Dentistry of Piracicaba, Department of Restorative Dentistry, Endodontics Division, Piracicaba, SP, Brazil
| | | | | | - Eduardo Buozi Moffa
- Centro Universitário das Faculdades Associadas - Unifae, Department of Dentistry, São João da Boa Vista, SP, Brazil
| | - Luiz Renato Paranhos
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Preventive and Community Dentistry, Uberlândia, MG, Brazil
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Dynamics of salivary markers of kidney functions in acute and chronic kidney diseases. Sci Rep 2020; 10:21260. [PMID: 33277585 PMCID: PMC7719178 DOI: 10.1038/s41598-020-78209-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 11/17/2020] [Indexed: 12/15/2022] Open
Abstract
Saliva can be used as an alternative diagnostic fluid enabling easy and non-invasive disease monitoring. Urea and creatinine can be measured in saliva and both were shown to be increased in renal failure. However, the dynamics of these markers during the development of kidney diseases is unknown. We aimed to describe the dynamics of salivary urea and creatinine in various animal models of acute kidney injury (AKI) and chronic kidney disease (CKD) and in patients with different stages AKI or CKD. Ninety Wistar rats underwent bilateral nephrectomy (BNX), ischemia–reperfusion injury (IRI) or glycerol-induced kidney injury to model AKI. CKD was modelled using 5/6 nephrectomy. In the clinical part 57 children aged 12.6 ± 4.9 years with AKI (n = 11) or CKD (n = 46) and 29 healthy controls (aged 10.2 ± 3.7 years) were enrolled. Saliva and blood samples were collected in both, animal experiments and the human study. In animal models of AKI, plasma urea and creatinine were higher than in controls. An increase of salivary urea and creatinine (twofold) was observed in BNX and IRI, but only after 12 h and 24 h, respectively. In glycerol nephropathy and 5/6 nephrectomy, salivary urea increased (by 100% and by 50%), while salivary creatinine did not change during the observation period. Salivary urea and creatinine were significantly higher in all patients compared to controls (threefold) and in both, AKI and CKD they were associated with the severity of renal failure. Plasma and salivary concentrations correlated only in children with renal failure (R = 0.72 for urea; R = 0.93 for creatinine), but not in controls (R = -0.007 for urea; R = 0.02 for creatinine). Our study indicates that during the development of renal impairment saliva could be used for non-invasive monitoring in higher stages of AKI or CKD, rather than for screening of early stages of kidney diseases.
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Rodrigues RPCB, de Andrade Vieira W, Siqueira WL, Blumenberg C, de Macedo Bernardino Í, Cardoso SV, Flores-Mir C, Paranhos LR. Saliva as an alternative to blood in the determination of uremic state in adult patients with chronic kidney disease: a systematic review and meta-analysis. Clin Oral Investig 2020; 24:2203-2217. [PMID: 32447524 DOI: 10.1007/s00784-020-03340-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 05/11/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To assess whether salivary urea and creatinine levels accurately reflect their serum levels in blood samples of adults to detect chronic kidney disease. MATERIALS AND METHODS A systematic review was conducted in eight electronic databases. The protocol was registered in PROSPERO. Only diagnostic test studies were included. The JBI critical appraisal tools assessed the risk of bias. A meta-analysis of proportions was performed. The GRADE tool assessed the quality of evidence and strength of recommendation across the studies included. RESULTS Eight studies met the eligibility criteria and were included. Six studies assessed salivary urea, and six studies assessed salivary creatinine. All studies presented moderate risk of bias. The meta-analysis depicted an overall sensitivity of 93.3% (95% CI = 88.6; 97.9) for salivary creatinine levels and 87.5% (95% CI = 83.2; 91.8) for salivary urea levels, while the overall specificity was 87.1% (95% CI = 82.8; 91.3) and 83.2% (95% CI = 65.0; 101.4) for salivary creatinine and urea levels, respectively. The overall accuracy of salivary creatinine was 5.2 percentage points higher compared with salivary urea levels (90.8% vs. 85.6%). According to the GRADE tool, the analysed outcomes were classified as having low to moderate level of certainty. CONCLUSION Compared with blood samples, salivary urea and creatinine levels presented high diagnostic values for chronic kidney disease screening, but should not be considered equivalent to levels obtained from blood at stages three, four, or five of the disease. CLINICAL SIGNIFICANCE Chronic kidney disease patients could receive a clinically significant benefit from replacing blood with saliva for potentially monitoring renal function. Saliva collection presents greater simplicity, comfort, safety, and lower collection cost.
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Affiliation(s)
| | - Walbert de Andrade Vieira
- Department of Restorative Dentistry, Endodontics Division, School of Dentistry of Piracicaba, State University of Campinas, UNICAMP, Piracicaba, Brazil
| | | | - Cauane Blumenberg
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | | | - Sérgio Vitorino Cardoso
- Division of Pathology, School of Dentistry, Federal University of Uberlândia, Uberlândia, Brazil
| | - Carlos Flores-Mir
- Division of Orthodontics, School of Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Luiz Renato Paranhos
- Division of Preventive and Community Dentistry, School of Dentistry, Federal University of Uberlândia, Uberlândia, Brazil.
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Flow-based method for the determination of biomarkers urea and ammoniacal nitrogen in saliva. Bioanalysis 2020; 12:455-465. [DOI: 10.4155/bio-2020-0036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Aim: Salivary urea and ammonium levels are potential biomarkers for chronic kidney disease. A fast and efficient assessment of these compounds in the saliva of healthy and diseased individuals may be a useful tool to monitor kidney function. Materials & methods: Ammonium ions were measured with an ammonia selective electrode after conversion to ammonia gas. A urease reactor was incorporated in the manifold to hydrolyze urea to ammonium, thereby providing values of ammonia from both urea and ammonium ions in the sample. The accuracy of the method was assessed by comparison with a commercially available kit for urea and ammonium determination. Conclusion: A sequential injection method for the biparametric determination of salivary urea and ammonium employing a single sequential injection manifold was successfully applied to samples collected from both healthy volunteers and chronic kidney disease patients.
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Manig F, Hellwig M, Pietz F, Henle T. Quantitation of free glycation compounds in saliva. PLoS One 2019; 14:e0220208. [PMID: 31532774 PMCID: PMC6750567 DOI: 10.1371/journal.pone.0220208] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 07/10/2019] [Indexed: 12/14/2022] Open
Abstract
In the course of the Maillard reaction, which occurs during heating of food but also under physiological condition, a broad spectrum of reaction products is formed. Among them, the advanced glycation endproducts (AGEs) Nε-carboxymethyllysine (CML), pyrraline (Pyr), methylglyoxal-derived hydroimidazolone 1 (MG-H1) and Nε-carboxyethyllysine (CEL) are the quantitatively dominating compounds during later reaction stages. Those dietary glycation compounds are under discussion as to be associated with chronic inflammation and the pathophysiological consequences of diseases such as diabetes. In the present study, the concentration of individual glycation compounds in saliva was monitored for the first time and related to their dietary uptake. Fasting saliva of 33 metabolically healthy subjects was analyzed with HPLC-MS/MS. The observed levels of individual glycation compounds ranged from 0.5 to 55.2 ng/ml and differed both intra- and interindividually. Patterns did not correlate with subject-related features such as vegetarianism or sports activities, indicating that dietary intake may play an important role. Therefore, six volunteers were asked to eat a raw food diet free of glycation compounds for two days. Within two days, salivary Pyr was lowered from median 1.7 ng/ml to a minimum level below the limit of detection, and MG-H1 decreased from 3.6 to 1.7 ng/ml in in a time-dependent manner after two days. Salivary CML and CEL concentrations were not affected. Therefore, measuring Pyr and MG-H1 in saliva is a suitable diagnostic tool to monitor the dietary intake and metabolic transit of glycation compounds present in heated foods.
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Affiliation(s)
- Friederike Manig
- Chair of Food Chemistry, Technische Universität Dresden, Dresden, Germany
- * E-mail: (TH); (MH); (FM)
| | - Michael Hellwig
- Chair of Food Chemistry, Technische Universität Dresden, Dresden, Germany
- * E-mail: (TH); (MH); (FM)
| | - Franziska Pietz
- Chair of Food Chemistry, Technische Universität Dresden, Dresden, Germany
| | - Thomas Henle
- Chair of Food Chemistry, Technische Universität Dresden, Dresden, Germany
- * E-mail: (TH); (MH); (FM)
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Bilancio G, Cavallo P, Lombardi C, Guarino E, Cozza V, Giordano F, Palladino G, Cirillo M. Saliva for assessing creatinine, uric acid, and potassium in nephropathic patients. BMC Nephrol 2019; 20:242. [PMID: 31272423 PMCID: PMC6609386 DOI: 10.1186/s12882-019-1437-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 06/24/2019] [Indexed: 12/20/2022] Open
Abstract
Background Lab tests on saliva could be useful because of low invasivity. Previous reports indicated that creatinine, uric acid, and potassium are measurable in saliva. For these analytes the study investigated methodology of saliva tests and correlations between plasma and saliva levels. Methods The study enrolled 15 healthy volunteers for methodological analyses and 42 nephropathic patients for plasma-saliva correlations (35 non-dialysis and 7 dialysis). Saliva was collected by synthetic swap right after venipuncture for blood withdrawal. Blood and saliva, unless otherwise indicated, were collected early in the morning after overnight fast and lab tests were performed in fresh samples by automated biochemistry (standard). Methodological analyses included blind duplicates, different collection mouth sites, day-to-day variability, different collection times, and freezing-thawing effects. Analyses on plasma-saliva correlations included post-dialysis changes. Results For saliva lab tests of all analytes, blind duplicates, samples from different mouth sites or of different days were not significantly different but were significantly correlated (differences ≤14.4%; R ≥ 0.620, P ≤ 0.01). For all analytes, mid-morning saliva had lower levels than but correlated with standard saliva (differences ≥15.8%; R ≥ 0.728, P ≤ 0.01). Frozen-thawed saliva had lower levels than fresh saliva for uric acid only (− 17.2%, P < 0.001). Frozen-thawed saliva correlated with fresh saliva for all analytes (R ≥ 0.818, P ≤ 0.001). Saliva and plasma levels differed but correlated with plasma for creatinine (R = 0.874, P < 0.001), uric acid (R = 0.821, P < 0.001) and potassium (R = 0.767, P < 0.001). Post-dialysis changes in saliva paralleled post-dialysis changes in plasma. Conclusion Saliva levels of creatinine, uric acid, and potassium are measurable and correlated with their plasma levels. Early morning fasting fresh saliva samples are advisable because later collection times or freezing lower the saliva levels of these analytes.
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Affiliation(s)
- Giancarlo Bilancio
- Department "Scuola Medica Salernitana", University of Salerno, Baronissi, SA, Italy.,Nephrology Clinic, University Hospital, Salerno, SA, Italy
| | | | | | - Ermanno Guarino
- Department "Scuola Medica Salernitana", University of Salerno, Baronissi, SA, Italy
| | - Vincenzo Cozza
- Department "Scuola Medica Salernitana", University of Salerno, Baronissi, SA, Italy
| | - Francesco Giordano
- Department "Scuola Medica Salernitana", University of Salerno, Baronissi, SA, Italy
| | | | - Massimo Cirillo
- Department Public Health, University of Naples "Federico II", Via Sergio Pansini, 5, 80131, Naples, Italy.
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Tvarijonaviciute A, Pardo-Marin L, Tecles F, Carrillo JD, Garcia-Martinez JD, Bernal L, Pastor J, Cerón JJ, Martinez-Subiela S. Measurement of urea and creatinine in saliva of dogs: a pilot study. BMC Vet Res 2018; 14:223. [PMID: 30029662 PMCID: PMC6053741 DOI: 10.1186/s12917-018-1546-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Accepted: 06/26/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Urea and creatinine in saliva have been reported to be possible markers of chronic kidney disease (CKD) in humans. The aim of this study was to assess if urea and creatinine could be measured in canine saliva, and to evaluate their possible changes in situations of CKD. RESULTS The spectrophotometric assays for urea and creatinine measurements in saliva of dogs showed intra- and inter-assay imprecision lower than 12% and coefficients of correlation close to 1 in linearity under dilution tests. Healthy dogs showed median salivary concentrations of urea of 39.6 mg/dL and creatinine of 0.30 mg/dL, whereas dogs with CKD showed median salivary urea of 270.1 mg/dL and creatinine of 1.86 mg/dL. Positive high correlations were found between saliva and serum activities of the two analytes (urea, r = 0.909; P < 0.001; creatinine, r = 0.819; P < 0.001). CONCLUSIONS Urea and creatinine concentrations can be measured in canine saliva with commercially available spectrophotometric assays. Both analytes showed higher values in saliva of dogs with CKD compared with healthy dogs and their values were highly correlated with those in serum in our study conditions.
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Affiliation(s)
- Asta Tvarijonaviciute
- From the Interdisciplinary Laboratory of Clinical Analysis (Interlab-UMU), Regional Campus of International Excellence “Campus Mare Nostrum”, University of Murcia, Campus of Espinardo s/n, 30100 Murcia, Spain
| | - Luis Pardo-Marin
- From the Interdisciplinary Laboratory of Clinical Analysis (Interlab-UMU), Regional Campus of International Excellence “Campus Mare Nostrum”, University of Murcia, Campus of Espinardo s/n, 30100 Murcia, Spain
| | - Fernando Tecles
- From the Interdisciplinary Laboratory of Clinical Analysis (Interlab-UMU), Regional Campus of International Excellence “Campus Mare Nostrum”, University of Murcia, Campus of Espinardo s/n, 30100 Murcia, Spain
| | - Juana Dolores Carrillo
- From the Department of Animal Medicine and Surgery, School of Veterinary Medicine, University of Murcia, Murcia, Spain
| | - Juan Diego Garcia-Martinez
- From the Interdisciplinary Laboratory of Clinical Analysis (Interlab-UMU), Regional Campus of International Excellence “Campus Mare Nostrum”, University of Murcia, Campus of Espinardo s/n, 30100 Murcia, Spain
| | - Luis Bernal
- From the Interdisciplinary Laboratory of Clinical Analysis (Interlab-UMU), Regional Campus of International Excellence “Campus Mare Nostrum”, University of Murcia, Campus of Espinardo s/n, 30100 Murcia, Spain
| | - Josep Pastor
- From the Animal Medicine and Surgery Department, School of Veterinary Medicine, University Autonomous of Barcelona, Barcelona, Spain
| | - José J. Cerón
- From the Interdisciplinary Laboratory of Clinical Analysis (Interlab-UMU), Regional Campus of International Excellence “Campus Mare Nostrum”, University of Murcia, Campus of Espinardo s/n, 30100 Murcia, Spain
| | - Silvia Martinez-Subiela
- From the Interdisciplinary Laboratory of Clinical Analysis (Interlab-UMU), Regional Campus of International Excellence “Campus Mare Nostrum”, University of Murcia, Campus of Espinardo s/n, 30100 Murcia, Spain
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Kovalčíková A, Janšáková K, Gyurászová M, Podracká Ľ, Šebeková K, Celec P, Tóthová Ľ. Salivary creatinine and urea are higher in an experimental model of acute but not chronic renal disease. PLoS One 2018; 13:e0200391. [PMID: 29979784 PMCID: PMC6034877 DOI: 10.1371/journal.pone.0200391] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 06/24/2018] [Indexed: 12/12/2022] Open
Abstract
Plasma creatinine and urea are commonly used markers of kidney function in both acute and chronic renal failure. The needed repeated blood collection is associated with pain, stress and might lead to infections. Saliva has the potential to be a non-invasive alternative diagnostic fluid. The use of saliva in clinical practice is limited, since many factors affect the concentration of salivary biomarkers. The aim of our study was to analyze salivary creatinine and urea in the animal models of acute and chronic renal disease. Bilateral nephrectomy and adenine nephropathy were induced in adult male mice. Both, plasma creatinine and urea were higher in animals with renal failure compared to controls. Salivary creatinine was higher by 81% and salivary urea by 43% in comparison to the control group, but only in animals with bilateral nephrectomy and not in adenine nephropathy. Our results indicate that the increase of salivary creatinine and urea depends on the experimental model of renal failure and its severity. Further studies are needed to monitor the dynamics of salivary markers of renal function and to reveal determinants of their variability.
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Affiliation(s)
- Alexandra Kovalčíková
- Institute of Molecular Biomedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Katarína Janšáková
- Institute of Molecular Biomedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Marianna Gyurászová
- Institute of Molecular Biomedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Ľudmila Podracká
- 1st Department of Pediatrics, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Katarína Šebeková
- Institute of Molecular Biomedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Peter Celec
- Institute of Molecular Biomedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia
- Institute of Pathophysiology, Faculty of Medicine, Comenius University, Bratislava, Slovakia
- Department of Molecular Biology, Faculty of Natural Sciences, Comenius University, Bratislava, Slovakia
| | - Ľubomíra Tóthová
- Institute of Molecular Biomedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia
- * E-mail:
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Bilancio G, Cavallo P, Lombardi C, Guarino E, Cozza V, Giordano F, Palladino G, Cirillo M. Salivary levels of phosphorus and urea as indices of their plasma levels in nephropathic patients. J Clin Lab Anal 2018; 32:e22449. [PMID: 29603373 DOI: 10.1002/jcla.22449] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 03/12/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Phosphorus and urea are measurable in saliva. Measurements of saliva phosphorus (S-Pho) and saliva urea (S-Urea) could be useful because of low invasivity. Data are limited to saliva tests methodology and to correlations between plasma and saliva compositions. S-Pho and S-Urea were investigated focusing on blind duplicates, differences between collection sites, differences between collection times, freezing-thawing effects, and plasma-saliva correlations. METHODS Tests were performed using fresh saliva collected by synthetic swap early morning after overnight fast (standard). Methodology was investigated in fifteen healthy volunteers. Plasma-saliva correlations were investigated in thirty nephropathic outpatients. RESULTS S-Pho and S-Urea in all measurements ranged above detection limits (0.3 mmol/L). In healthy volunteers, S-Pho and S-Urea were similar in duplicates (results for S-Pho and S-Urea: % difference between samples ≤ 4.85%; R between samples ≥ .976, P < .001), in samples from different mouth sites (≤4.24%; R ≥ .887, P < .001), and in samples of different days (≤5.61%; R ≥ .606, P < .01) but, compared to standard, were substantially lower in after-breakfast samples (-28.0% and -21.3%; R ≥ .786, P < .001) and slightly lower in frozen-thawed samples (-12.4% and -5.92%; R ≥ .742, P < .001). In nephropathic patients, S-Pho was higher than but correlated with plasma phosphorus (saliva/plasma ratio 4.80; R = .686, P < .001), whereas S-Urea and plasma urea were similar and correlated with each other (saliva/plasma ratio 0.96; R = .944, P < .001). Post-dialysis changes in S-Pho and S-Urea paralleled post-dialysis changes in plasma phosphorus and urea. CONCLUSION S-Pho and S-Urea reflect plasma phosphorus and plasma urea. Early morning fasting fresh samples are advisable because collection time and freezing-thawing affect saliva tests.
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Affiliation(s)
- Giancarlo Bilancio
- Department "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy.,Nephrology Clinic, University Hospital, Salerno, Italy
| | | | | | - Ermanno Guarino
- Department "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Vincenzo Cozza
- Department "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Francesco Giordano
- Department "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
| | | | - Massimo Cirillo
- Department "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy.,Nephrology Clinic, University Hospital, Salerno, Italy
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