Diagnostic Performance of Renal Function and Mineral Metabolism Biomarkers in Female Patients with Kidney Failure

الملخص

The last stage of chronic kidney disease is kidney failure, which is characterized by critical alterations in the renal system’s ability to excrete waste, as well as disruptions to body’s control mechanisms of the mineral and endocrine system. Urea and creatinine are still valuable markers in assessing renal functions, as changes in calcium and parathyroid hormone (PTH) indicate the beginning of chronic kidney disease and mineral and bone disorder. Thus, these markers can be valuable in diagnosing kidney failure and monitoring disease progression.

Objective: The study aimed to analyze the changes in renal function and mineral metabolism markers in female patients with kidney failure and the potential of these changes to support a diagnosis.

Methodology : A case-control study was conducted at Nasiriyah Teaching Hospital, in Thi-Qar Governorate, Iraq. The study included 200 female participants in the age range of 45 to 55, of which 100 were kidney failure patients, and the other 100 were apparently healthy and served as controls. Standard laboratory tests were performed, and the levels of serum urea, creatinine, calcium, and parathyroid hormone were measured. Data are presented as mean ± standard deviation. Group comparisons were performed using the independent samples t-test. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic potential of the biomarkers. A p-value of less than 0.05 was considered statistically significant.

Results: Kidney failure patients exhibited significantly higher serum urea and creatinine levels compared with healthy controls (110.6 ± 22.8 vs. 27.9 ± 6.3 mg/dL and 6.5 ± 1.9 vs. 0.89 ± 0.19 mg/dL, respectively; P < 0.001). Serum calcium levels were significantly reduced in patients (7.4 ± 0.5 mg/dL) compared with controls (9.6 ± 0.7 mg/dL; P < 0.001), while serum PTH levels were markedly elevated in the patient group (461.2 ± 133.4 vs. 44.3 ± 16.6 pg/mL; P < 0.001). ROC analysis showed high areas under the curve for urea, creatinine, and PTH, demonstrating excellent diagnostic performance. In contrast, calcium showed inverse discriminatory behavior reflecting hypocalcemia in kidney failure.

Conclusions: Kidney failure in female patients is linked with pronounced renal deficiency coupled with considerable imbalances in mineral metabolism, as indicated by increased levels of urea, creatinine, and PTH, and decreased levels of serum calcium. Urea, creatinine, and PTH had considerable diagnostic value in differentiating patients with kidney failure from non-affected subjects, whereas calcium had additional diagnostic value in assessing the status of metabolic imbalances. The findings validate the importance of assessing both renal and mineral metabolism for the diagnosis of kidney failure.