Lipid and nutritional profiles of Caribbean patients with chronic kidney disease.

Aim: Chronic kidney disease (CKD) is marked by the deterioration of kidney function and derangement in lipid metabolism. Thus, we aim at evaluating the lipid and nutritional parameters of Caribbean patients with CKD. Methods: The study recruited 88 CKD patients and 105 apparently healthy subjects. Blood glucose, urea, creatinine, albumin, uric acid, total cholesterol, triglycerides, HDL-cholesterol, VLDL, and LDL were measured in duplicate on the Vitros 4600 Multi-Channel Chemistry Auto-Analyzer (Johnson & Johnson Ortho-Clinical Diagnostics Inc., Rochester NY, USA) in our laboratory. The Statistical Package for the Social Sciences (SPSS, version 20) was used for statistical analysis. Results: Mean levels of diastolic blood pressure (p < 0.05), age, and systolic blood pressure between the patients and the healthy controls (p < 0.001) were different. In addition, mean levels of BUN (p < 0.05), serum creatinine, and uric acid were higher and eGFR lower in the patients compared with the healthy controls (p < 0.001). The mean levels of albumin, glucose, triglycerides, HDL-cholesterol, and VLDL (p < 0.001) also differed between patients and healthy controls. Negative correlation between eGFR and triglycerides and a positive correlation between eGFR and total cholesterol, HDL-c and LDL were observed. The prevalence of hypoalbuminemia, hypercholesterolemia and underweight were 27.27%, 57.95% and 4.55% respectively in patients, compared with 10.48%, 44.74% and 2.86% respectively in healthy controls. Conclusion: Dyslipidemia is common in CKD patients and is therefore, imperative that, routine lipid profile analysis be detailed in order to check any trend towards the development of CVD.

Measurement of neutrophil gelatinase-associated lipocalin (NGAL) in patients with non-communicable diseases: any additional benefit?

AIM: Chronic kidney disease (CKD) is one of the major complication from non-communicable diseases (NCD), such as diabetes or hypertension. We aimed to determine if routine measurement of neutrophil gelatinase-associated lipocalin (NGAL) in NCD patients could provide additional benefit for diagnosing kidney disease. METHODS: Fasting serum NGAL, urea, creatinine, uric acid and albumin were measured in 298 NCD patients. Estimated glomerular filtration rate (e-GFR) was calculated using the CKD-EPI equation. Multiple linear regression modeling was used for analysis. RESULTS: CKD patients have the highest levels of NGAL than the other NCD patients (p < 0.001). Although NGAL was significantly related to e-GFR, creatinine, urea and albumin in CKD-patients (p < 0.001) and not in the other NCD patients (p > 0.05), only serum creatinine predicted NGAL levels in CKD-patients (p < 0.001). CONCLUSION: NGAL level is best associated with serum creatinine only in patients with CKD and NGAL measurement may not be cost effective as a routine kidney function test in NCD patients in under-resourced economies.