Evaluation of Insulin with Gold Standard Creatinine and eGFR as Markers for Kidney Failure Among Dialysis Patient in Nnewi North LGA, Anambra State

Abstract

This study evaluated the relationship between insulin, creatinine, and estimated glomerular filtration rate (eGFR ) as biomarkers for kidney failure among dialysis patients in Nnewi North Local Government Area (LGA) of Anambra State, Nigeria. A cross-sectional design was employed, involving 45 patients on dialysis and 45 healthy controls aged 18-80 years. Anthropometric measurements, blood samples, and clinical data were collected, and biomarkers were analyzed using ELISA and Jaffe reaction methods. Results revealed significantly higher levels of creatinine (2.71 ± 0.88 mg/dL) and insulin (30.40 ± 35.82 uU/mL) in dialysis patients compared to controls (0.871 ± 0.24 mg/dL, 4.71 ± 6.46 uU/mL, and 1.07 ± 0.98 ng/mL, respectively), alongside significantly lower eGFR (27.15 ± 12.76 mL/min) in dialysis patients versus controls (118.84 ± 57.54 mL/min). No significant gender differences were observed among dialysis patients, but male controls exhibited higher insulin levels. Strong negative correlations were found between eGFR and creatinine in both groups, while insulin positively correlated with BMI in dialysis patients in controls. These findings underscore the metabolic and renal dysfunction in dialysis patients, highlighting the importance of monitoring these biomarkers for effective management of chronic kidney disease (CKD). The study recommends routine biomarker monitoring, management of insulin resistance, and region-specific research to improve CKD outcomes in Nnewi North LGA. Limitations include the cross-sectional design and sample size, suggesting the need for longitudinal studies with larger cohorts.