Article Sidebar

Download
PDF

Main Article Content

Abstract

ABSTRACT
Background. Bilirubin has potent antioxidant properties and higher bilirubin levels even within normal range are associated with beneficial effects in HD patients. However, the presence of oxidative stress may deplete antioxidants including serum bilirubin. In this work, we sought to evaluate the serum bilirubin levels in chronic kidney disease patients before and after haemodialysis. Methods. We carried out a 9 months cross sectional  study in  adults  patients  on MHD  for at least three months  at the Yaoundé University Teaching hospital. Socio-demographic, clinical and para-clinical data were collected. Blood samples for serum bilirubin were collected before and after HD sessions.  Measurement of serum bilirubin was done using spectrophotometer. The association between the variables of interest was evaluated with the Mann Whitney and Pearson chi-square tests of correlation with a significant statistical level, P<0.05. Results. We included 60 participants (68.3% males) with a mean age of 48.7±13.6 years. The median dialysis vintage was 14.0 [6.0-32.5] months with 90% using arterio-venous as vascular access. The median values [IQR] of total bilirubin and direct bilirubin before HD were 4.4 [03.2 - 06.4] mg/l and 1.5 [01.2 - 01.9] mg/l and after HD, were 5.2 [03.6 - 08.2] mg/l and 1.6 [01.4 - 02.1] mg/l respectively. Conclusion. Serum bilirubin increases after haemodialysis due to haemoconcentration though serum levels may be depleted by the presence of oxidative stress often presence in haemodialysis patients
 
RÉSUMÉ
Introduction : la bilirubine possède de puissantes propriétés antioxydantes et des taux élevés de bilirubine, même dans les limites de la normale, sont associés à des effets bénéfiques chez les patients atteints de la maladie rénale chronique. Cependant, la présence d'un stress oxydatif peut épuiser les antioxydants, y compris la bilirubine sérique.  Notre objectif était d'évaluer les taux de bilirubine sérique chez les patients atteints de maladie rénale chronique avant et après l'hémodialyse. Méthodes.  Nous avons mené une étude transversale de 9 mois chez des adultes en hémodialyse (HD) depuis au moins trois mois au CHU de Yaoundé. Les données sociodémographiques, cliniques et paracliniques ont été recueillies. Des échantillons de sang pour la bilirubine sérique ont été prélevés avant et après les séances d'HD. La mesure de la bilirubine sérique a été effectuée à l'aide d'un spectrophotomètre. L'association entre les variables d'intérêt a été évaluée avec les tests de corrélation de Mann Whitney et du chi-carré de Pearson avec un niveau statistique significatif, P<0,05. Résultats. Nous avons inclus 60 participants (68,3% d'hommes) avec un âge moyen de 48,7±13,6 ans. L'ancienneté médiane de la dialyse était de 14,0 [6,0-32,5] mois avec 90% utilisant l'artério-veineux comme accès vasculaire. Les valeurs médianes [IQR] de la bilirubine totale et de la bilirubine directe avant HD étaient respectivement de 4,4 [03,2 - 06,4] mg/l et 1,5 [01,2 - 01,9] mg/l et après HD de 5,2 [03,6 - 08,2] mg/l et 1,6 [01,4 - 02,1] mg/l. Conclusion.  La bilirubine sérique augmente après l'hémodialyse en raison de l'hémoconcentration, bien que les niveaux sériques puissent être réduits par la présence d'un stress oxydatif souvent présent chez les patients hémodialysés.

Keywords

haemodialysis, serum total and direct bilirubin anglais

Article Details

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Author Biographies

NZANA Victorine B, Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon ; Yaounde Central Hospital

1Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon

2 Yaounde Central Hospital

MAIMOUNA Mahamat, 1Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon 3 Yaounde General Hospital

1Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon

3 Yaounde General Hospital

MAHEG André B, Department of Biochemistry, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon

Department of Biochemistry, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon

KOWO Mathurin , Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon; Yaounde University Teaching hospital, Yaounde, Cameroon

1Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon

5 Yaounde University Teaching hospital, Yaounde, Cameroon

KAZE Francois, Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon; Yaounde University Teaching hospital, Yaounde, Cameroon

1Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon

5 Yaounde University Teaching hospital, Yaounde, Cameroon

AMA MOOR Vicky, Department of Biochemistry, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon; Yaounde University Teaching hospital, Yaounde, Cameroon

Department of Biochemistry, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon

5 Yaounde University Teaching hospital, Yaounde, Cameroon

How to Cite
Victorine B, N., Mahamat, M. . ., André B, M. ., Mathurin , K. . ., Francois, K. ., & MOOR Vicky, A. . (2023). Variation of Serum Bilirubin in Chronic Kidney Disease Cameroonian Patients on Maintenance Haemodialysis . HEALTH SCIENCES AND DISEASE, 24(6). https://doi.org/10.5281/hsd.v24i6.4483
Download Citation
Endnote/Zotero/Mendeley (RIS)
BibTeX

References

  1. Li J., Liu D., Liu Z. Serum total bilirubin and progression of chronic kidney disease and mortality: a systematic review and meta-analysis. Frontiers in Medicine. 2021 Jan 25;7:549.
  2. Alvarez F., Berg P.A., Bianchi F.B., Bianchi L., Burroughs A.K., Cancado E.L., et al. International autoimmune hepatitis group report: review of criteria for diagnosis of autoimmune hepatitis. Journal of Hepatology. 1999;31(5):929–38.
  3. Allen K.J., Gurrin L.C., Constantine C.C., Osborne N.J., Delatycki M.B., Nicoll A.J., et al. Iron-overload-related disease in HFE hereditary hemochromatosis. The New England Journal of Medicine. 2008;358(3):221–30.
  4. Sorbi D., Boynton J., Lindor K.D. The ratio of aspartate aminotransferase to alanine aminotransferase: potential value in differentiating nonalcoholic steatohepatitis from alcoholic liver disease. American Journal of Gastroenterology. 1999;94(4):1018–22.
  5. Al-Wakeel J., Malik G.H., al-Mohaya S., Mitwalli A., Baroudi F., el Gamal H., et al. Liver disease in dialysis patients with antibodies to hepatitis C virus. Nephrology, Dialysis, Transplantation: Official Publication of the European Dialysis and Transplant Association - European Renal Association. 1996;11(11):2265–8.
  6. Liberato I.R. de O., Lopes E.P. de A., Cavalcante M.A.G. de M., Pinto T.C., Moura I.F., Loureiro Júnior L. Liver enzymes in patients with chronic kidney disease undergoing peritoneal dialysis and hemodialysis. Clinics (Sao Paulo). 2012;67(2):131– 4.
  7. Ono K., Ono T., Matsumata T. The pathogenesis of decreased aspartate aminotransferase and alanine aminotransferase activity in the plasma of hemodialysis patients: the role of vitamin B6 deficiency. Clinical Nephrology. 1995;43(6):405–8.
  8. Sette L.H.B.C., Almeida Lopes E.P. de. Liver enzymes serum levels in patients with chronic kidney disease on hemodialysis: a comprehensive review. Clinics (Sao Paulo). 2014;69(4):271–8.
  9. Su H.H., Kao C.M., Lin Y.C., Lin Y.C., Kao C.C., Chen H.H., et al. Relationship between serum total bilirubin levels and mortality in uremia patients undergoing long-term hemodialysis: A nationwide cohort study. Atherosclerosis. 2017;265:155–61.
  10. Tanaka M., Fukui M., Okada H., Senmaru T., Asano M., Akabame S., et al. Low serum bilirubin concentration is a predictor of chronic kidney disease. Atherosclerosis. 2014;234(2):421–5.
  11. Wang J., Wang B., Liang M., Wang G., Li J., Zhang Y., et al. Independent and combined effect of bilirubin and smoking on the progression of chronic kidney disease. Clinical Epidemiology. 2018 Jan 15;10:121–32.
  12. Targher G., Zoppini G., Cesare Guidi G., Lippi G. Relationship between serum bilirubin and kidney function in non-diabetic and diabetic individuals. Kidney International. 2009 Apr;75(8):863.
  13. Ryu S., Chang Y., Zhang Y., Woo H.Y., Kwon M.J., Park H., et al. Higher serum direct bilirubin levels were associated with a lower risk of incident chronic kidney disease in middle aged Korean men. PloS One. 2014;9(2):e75178.
  14. Neves P.D.M. de M., Sesso R. de C.C., Thomé F.S., Lugon J.R., Nascimento M.M. Brazilian dialysis survey 2019. Jornal Brasileiro De Nefrologia: ’Orgao Oficial De Sociedades Brasileira E Latino-Americana De Nefrologia. 2021;43(2):217–27.
  15. Halle M.P., Ashuntantang G., Kaze F.F., Takongue C., Kengne A.P. Fatal outcomes among patients on maintenance haemodialysis in sub-Saharan Africa: a 10-year audit from the Douala General Hospital in Cameroon. BMC Nephrology. 2016;17(1):165.
  16. García G.G., Iyengar A., Kaze F., Kierans C., Padilla-Altamira C., Luyckx V.A. Sex and gender differences in chronic kidney disease and access to care around the globe. Seminars in Nephrology. 2022;42(2):101–13.
  17. Halle M.P., Takongue C., Kengne A.P., Kaze F.F., Ngu K.B. Epidemiological profile of patients with end stage renal disease in a referral hospital in Cameroon. BMC Nephrology. 2015;16(1):59.
  18. Sudha R., Dheepthi C.K., Ronald J. Association of serum bilirubin levels with cardiometabolic risk factors in maintenance hemodialysis patients. National Journal of Basic Medical Sciences. 2019;9 (3)121-127
  19. Park W.Y., Koh E.S., Kim S.H., Kim Y.O., Jin D.C., Song H.C., et al. Serum gamma-glutamyltransferase levels predict clinical outcomes in hemodialysis patients. PLoS One. 2015;10(9): e0138159.
  20. Gul M., Kalkan A.K., Uyarel H. Serum bilirubin: a friendly or an enemy against cardiovascular diseases? Journal of Critical care. 2014;29(2):305-306.
  21. Do Sameiro-Faria M., Kohlova M., Ribeiro S., Rocha-Pereira P., Teixeira L., Nascimento H., et al. Potential cardiovascular risk protection of bilirubin in end-stage renal disease patients under hemodialysis. BioMed Research International. 2014;2014:175286.

Most read articles by the same author(s)