Study of risk factors and predictive markers of Chronic kidney disease (CKD) in Djamaa Hemodialysis Patients, and assessment of water quality effect (major risk factor) on kidney function in rats Wistar

Abstract

Chronic kidney Disease(CKD) is recognized as a major health problem, Faced with these problems, this study aims to identify some predictive and risk factors of CKD and to evaluate some biological and oxidative stress markers in HD patients of Djamaa (El-Oued) region, on the other hand in this work we are evaluated the water quality of the Djamaa region and study its effect on some markers of renal function in rats . Our socioeconomic and clinic risk factors study was conducted on 77 voluntary individual divided into 41 persons reserved as a control and 36 HD patients are recruited from HD service of Hospital Saad Dahleb Djamaa .They are represented by the mean age 46,32 years and their origin cover all Djamaa region. For biological markers study of HD patients , We are selected 21 control with mean age 39.00 ± 3.41years and 20 patients with mean 51.40 ± 3.64 years on which some biochemical, Hematological and oxidative stress markers were estimated. To test the effect of Tap water on renal function we used 3 groups of rats. Also We are relied the analysis of Odds ratio, student analysis, correlation ratio analysis, and Rook analysis for the statistical study of this work. Our results of Socioeconomic and clinical factors study illustrate the high relationship of CKD and Diabetes, urinary problem and arterial hyper pressure as a frequently risk factors also renal herbal medicine, drugs nephrotoxic and Disease before CKD are the very important risk factors OR(62.00 - 25.45) while that additive soft drink, spices and amount of water are significant (P<0.05) protective factors against CKD when OR ( 0.232 - 0.352). Our biological study demonstrate a significant variations (P<0.05) in biochemical parameters , Hematological markers , electrolytes levels and oxidative stress markers which represented an important significant(P<0.05) specificity of GSH(32%,AUC=31%), ORAC and FRAP activities(87%,AUC=77% and 73%,AUC=85%) respectively. also we notice a significant correlation between oxidative stress markers and some biochemical parameters of kidney function. In addition, we found a significant deference in some minerals and electrolytes levels between some spring ,tap and filtered water of deferent areas of Djamaa region which represented a significant effects on renal function shown in a remarkable changes of biological markers of rats drink water during 60 days of the experiment where the TW represented a high risk for kidney dysfunction while it contributes to significant variation on oxidant stress markers as MDA level and antioxidant enzymes as GSH, CAT, GST and SOD also biochemical and hematological markers illustrate an significant modifications which indicate to the renal disorder and anemia consequents while that the FW is represented a significant effect on renal function and biological markers studied but did not very deferent with TW results. Finally, we conclude that there are a most socioeconomic and clinical risk factors for CKD also tap water and filtered water are an important risk factor for renal function while there may contribute to renal dysfunction and CKD in Djamaa population. In addition, GSH, ORAC and FRAP activities represent very important predictive factors for the disease studied where its can suggested in prognostic parameters of CKD.