Impact of viral infections on urea and creatinine levels in patients with chronic kidney disease on haemodialysis

Abstract

Background: Chronic kidney disease (CKD) has emerged as a world-wide public health problem with substantial morbidity and mortality. Chronic viral infection is associated with a higher risk of death in patients with CKD undergoing haemodialysis.

Objective: To evaluate the impact of viral infections on urea and creatinine levels in viral infected CKD patients on haemodialysis.

Method: Retrospective study of 164 consecutive CKD patients referred to the laboratory for HIV, HBV, HCV, urea, electrolytes and creatinine from the dialysis unit of Abdullahi Wase Specialist Hospital,Kano, Nigeria between January 2006 and December 2008 was done. They consisted of 114 males and 50 females. The studied parameters were evaluated using standard routine methods.

Results: Twenty six (15.9%) out of the 164 patients were positive for viral infections. The mean urea level in viral infected CKD patients was higher (47.5±3.9mmol/L vs 40.8±1.7mmol/L; p<0.002) than non-viral infected patients. Similarly, mean creatinine level in the viral infected patients was higher than the non-viral infected counterparts (1096±116 vs  973±28mmol/L; p<0.001). The mean urea level in the HBV infected  patients was higher (54.3±4.3mmol/L) than the HIV (42.7±4.9; p<0.05) and HCV (23.4±0.2mmol/L;p<0.001) infected CKD patients.
Conclusion: Viral infections strongly impacted on the kidney in CKD and
haemodialysis patients, hence exacerbation of disease progression. Treatment and prevention of viral infections should be promoted.