الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The concept of kidney disease shifted from that of an uncommon lifethreatening condition requiring care by nephrologists to that of a common condition with a range of severity meriting attention by general internists,
and demanding strategies for prevention, early detection, and management.
CKD is a heterogeneous group of disorders characterized by
alterations in kidney structure and function, which manifest in various ways
depending upon the underlying cause or causes and the severity of disease.
CKD is defined by the presence of kidney damage or decreased
kidney function for three or more months, irrespective of the cause.
The persistence of the damage or decreased function for at least three
months is necessary to distinguish CKD from acute kidney disease. Kidney
damage refers to pathologic abnormalities, whether established via renal
biopsy or imaging studies, or inferred from markers such as urinary
sediment abnormalities or increased rates of urinary albumin excretion.
Decreased kidney function refers to a decreased glomerular filtration rate
(GFR), which is usually estimated (eGFR) using serum creatinine and one of
several available equations.
The composition of blood and urine reflects not only functional
disorders of the nephron but also various systemic disorders. Practical
evaluation of kidney status in individual with renal disease includes
examination of:
1. Circulating levels of non-protein nitrogenous compounds.
2. Creatinine (Cr).
3. Renal concentration ability.
4. Glomerular filtration rate (GFR). Any diagnostic tool that could catch kidney disease in its early stages
can save these lives and keep people from having to enduse dialysis or
serious operations. The kidney’s main responsibility is cleaning the blood of
waste. Because urine forms mainly through passive diffusion, just like
saliva, many of blood’s components exchanged at the kidney are also
exchanged at the salivary glands.
Blicharz et al. suggest that the measurement of biomarkers in saliva
may be an effective alternative method for monitoring the effectiveness of
hemodialysis. Monitoring of markers in saliva instead of serum is
advantageous because saliva collection is a noninvasive, simple, and
inexpensive approach with minimal infectious risk that can be performed by
the patient with no need for involvement of medical personnel. Saliva can be
tested at home, thus saving the need for a visit to the clinic or hospital.
The aim of the present study is to explore the changes and clinical
significance of saliva urea and creatinine in both healthy people and chronic
kidney disease patients, and to provide a non invasive, quick, accurate and
reliable test to diagnose kidney disease.
This work included Fifty persons. they were 36 males and 14 females,
with age ranged from 23 to 74 years with mean age 47.6 ±12.14. Members
of this study were categorized in the following two groups:
Group I: chronic kidney disease patients which which consists of 40
patients subdivided into 30 End stage renal disease patients on regular
hemodialysis and 10 chronic kidney disease patients in different stages
except stage 5. They are 28 males and 12 females. Their age ranged from 31
to 74 years with mean 48 ± 11.42 years.
Summary
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Group II: consists of 10 healthy persons. They are 8 males and 2 females.
Their age ranged from 23 to 64 years with 40.7 ± 12.56
All patients and controls were subjected to the follwings:
• Full history taking including the present and the past history of the
illness and full clinical examination.
• Labaratory investigations: routine and specific.
• Serum urea, creatinine.
• Salivary urea and creatinine.
Results of this study showed non significant difference between the
studied groups regarding to age, sex. There is significant difference between
the studied groups regarding to serum creatinine, serum urea, saliva
creatinine and saliva urea.
Regarding to the results of correlation .this study showed a significant
positive correlation between serum creatinine and saliva creatinine in
healthy group, CKD patients and End stage renal disease patients .There is
also positive correlation between serum urea and saliva urea in healthy
group, CKD patients and End stage renal disease patients.
Concerning the ROC curve of saliva urea, saliva creatinine, serum urea
and serum creatinine of CKD and ESRD patients for diagnosis efficiency
evaluation the current study shows that salivary creatinine was more
sensitive than serum creatinine but serum urea was more sensitive than
salivary urea. The specificity of saliva creat, urea, serum creat, urea
respectively were higher than 80 %.
Summary
89
The gained data from our study reveal that:
• The concentration of urea and creatinine in both the saliva and the
serum were positively correlated in healthy individuals and CKD
patients.
• The levels of saliva urea and creatinine in the CKD patients were
significantly higher than those of healthy people.
• Measurment of saliva urea and creatinine is a simple, noninvasive and
quick method.