Abstract: SA-PO084

Assessment the Utility of Finger-Nail Creatinine to Differentiate between AKI and CKD

Session Information

Category: Acute Kidney Injury

  • 003 AKI: Clinical and Translational

Authors

  • Shinde, Nilesh, Dr. D Y Patil Medical College, Pune, India, Pune, Maharashtra, India
  • Dighe, Tushar A., Dr. D Y Patil Medical College, Pune, India, Pune, Maharashtra, India
  • Sajgure, Atul, Dr. D Y Patil Medical College, Pune, India, Pune, Maharashtra, India
  • Mulay, Atul, Dr. D Y Patil Medical College, Pune, India, Pune, Maharashtra, India
  • Bale, Charan Bhadrappa, Dr. D Y Patil Medical College, Pune, India, Pune, Maharashtra, India
  • Sharma, Ashwini, Dr. D Y Patil Medical College, Pune, India, Pune, Maharashtra, India
  • Goel, Abhishek, Dr. D Y Patil Medical College, Pune, India, Pune, Maharashtra, India
  • Mogal, Vajed, Dr. D Y Patil Medical College, Pune, India, Pune, Maharashtra, India
  • Shete, Pratik, Dr. D Y Patil Medical College, Pune, India, Pune, Maharashtra, India
  • Telang, Shirin, shayadri hospital, kothrud, pune, Pune, India
Background

It is necessary to establish if azotemia is acute or chronic as it plays vital role in initiating treatment and in preventing its progression. When a patient presents with renal failure, it is often difficult to ascertain whether the individual is suffering from acute or chronic renal failure. Efforts were made to use fingernail creatinine to differentiate between the two. While some studies found this useful, there are studies which were inconclusive. OBJECTIVE: - To determine usefulness of finger-nail creatinine to differentiate between Acute Kidney Injury and Chronic Kidney Disease.

Methods

In this prospective observational cohort study conducted at tertiary health care centre, 20 patients were selected for the study. Out of which 10 patients were diagnosed as Acute Kidney Disease (AKI) and 10 patients were diagnosed as chronic Kidney disease (CKD) with 30 days of dialysis vintage. 10 healthy volunteers were also included in the study as controls. For estimating finger-nail creatinine concentrations, fingernails of all participating subjects were clipped and collected separately in plain tubes. The nails were cleaned under tap water, dried & the weight was recorded. The Nail creatinine was extracted in water first by pulverization, followed by mechanical powdering. Sample powder incubated at 45°C for 2 hrs, centrifuged and then assayed by Alkaline Picrate-method on semi Auto Biochemistry Analyzer (Robonik).

Results

We found that when nail creatinine level in AKI (30.41 +/- 4.32 micrograms/g of nails) was significantly low compared with nail creatinine in CKD (91.59 +/- 47.76 micrograms/g of nails) [p-value (Two-tailed unpaired T test) 0.0013]. However, when nail creatinine level in AKI compared with nail creatinine in healthy volunteer (33.99 +/- 4.54 micrograms/g of nails), there was no significant difference [p-value (Two-tailed unpaired T test) 0.088].

Conclusion

The finger-nail creatinine level in AKI was significantly low than finger-nail creatinine in CKD. Hence nail creatinine can be used as a one of the diagnostic tool to differentiate between AKI & CKD in patients presenting with renal failure.