Salivary Creatinine Estimation as an Alternative to Serum Creatinine in Patients with Obstetric Related Acute Kidney Disease

Introduction- Obstetric related acute kidney disease (ORAKD) contributes significantly to maternal& foetal morbidity& mortality. Its incidence is 3-7 % of overall cases of acute kidney injury (AKI) in India. It is most commonly observed in the post partum period& followed by cases seen in third trimester. Sepsis, preeclampsia& eclampsia are the leading causes of ORAKD in developing countries, while in developed countries, chronic hypertension& renal pathologies are the main causes. This clinical entity requires frequent serum analysis for diagnosis& monitoring of clinical outcomes& for evaluation of prognosis. Serum creatinine is considered as a gold standard renal function test in ORAKD. Blood sampling for estimation of S. creatinine is an invasive procedure, in contrast to its estimation from salivary assays which is a non invasive, simple,& cost effective procedure. Salivary creatinine evaluation is very helpful in patients suffering from clotting disorders like haemophilia& when venous access is compromised. The values of salivary creatinine show a positive correlation with values of serum creatinine. Aim 1. To establish a correlation between serum& salivary creatinine levels.2. To evaluate the role of salivary creatinine as an alternative modality of diagnosis& management in ORAKD. Methodology A prospective observational study was conducted on 200 women in the age group of 20-40 years, in the third trimester of pregnancy, in the Department of Obstetrics& Gynaecology, MGM MCH. The cases were divided into two groups. Group I consisted of 100 cases of ORAKD as a result of various etiologies such as PIH, preeclampsia, eclampsia& sepsis. Group II consisted of 100 cases which served as healthy control group. The study was carried out for a period of one year from May 2017& the subjects were followed until delivery& upto 6 weeks post partum. Cases& controls were compared on various parameters& the results statistically analysed. Results Serum& salivary creatinine showed a positive correlation in cases of ORAKD (group I) r=0.832. In the control group II, a negative correlation was found in serum& salivary creatinine levels r= -0.321. Conclusion Salivary creatinine estimation can be employed as an alternative diagnostic modality to serum creatinine estimation in ORAKD cases. Obstetric related acute kidney disease, Serum creatinine, Preeclampsia, Eclampsia, Sepsis, Renal Function Test