Assessment of Salivary Urea in Different Stages of Chronic Renal Failure Patients

The human kidneys are bean-shaped organs located in the retroperitoneum at the level of the waist. Each adult kidney weighs approximately 160 g and measures 10 to 15 cm in length.1 The kidneys are vital organs for maintaining a stable homeostasis. Kidney has many functions like regulating the acid–base and fluid electrolyte balance of the body by filtering blood, reabsorbing water and electrolytes, and excreting urea and other toxic metabolites. Renal diseases are classified based on onset as acute and chronic renal failure (CRF). Acute renal failure is reversible, whereas chronic is irreversible and progresses to end-stage renal failure.1-4 The term “uremia,” which was originally applied by Piorry and Heritier in 1840 for cases of renal failure and which at that time was taken to imply the retention of urine in the blood, has been used for the various syndromes associated with nitrogen retention. Chronic renal failure is now termed “chronic kidney” disease or (CKD).5 A system to classify stages of CKD is justified to permit a logical approach to diagnosis and therapy in these patients. A working group of the National Kidney Foundation (NKF) recently published clinical practice guidelines to aid physicians in diagnosing and managing CKD.6 Chronic renal failure is divided into stages according to the level of renal function present or the glomerular filtration rate (GFR). The glomerular filtration rate is the best overall measure of kidney function. Factors that influence GFR include both structural (or functional) kidney disease as well as patient age. In stage I CKD, patients have normal renal function (glomerular filtration rate > 90 cc/minute) but may have proteinuria or hematuria. In stage 2 CKD, patients have reduced renal function with GFR between 60 and 90 cc/minute. Stage 3 CKD reflects a GFR between 30 and 60 cc/minute. During stage 3 CKD, patients often start developing manifestations related to CKD, such as anemia and secondary hyperparathyroidism (HPTH). These patients are more likely to die from other comorbidities than 1,5Senior Lecturer, 2Professor and Head, 3Reader, 4Private Practioner, 6Senior Lecturer 1,5Department of Oral Medicine and Radiology, Narsinhbhai Patel Dental College and Hospital, Gujarat, India