School of Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan.
Department of Medical Education, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan.
Biosensors (Basel). 2022 Mar 17;12(3):178. doi: 10.3390/bios12030178.
The prevalence of chronic kidney disease (CKD) is increasing, and it brings an enormous healthcare burden. The traditional measurement of kidney function needs invasive blood tests, which hinders the early detection and causes low awareness of CKD. We recently designed a device with miniaturized coplanar biosensing probes for measuring salivary conductivity at an extremely low volume (50 μL). Our preliminary data discovered that the salivary conductivity was significantly higher in the CKD patients. This cross-sectional study aims to validate the relationship between salivary conductivity and kidney function, represented by the estimated glomerular filtration rate (eGFR). We enrolled 214 adult participants with a mean age of 63.96 ± 13.53 years, of whom 33.2% were male. The prevalence rate of CKD, defined as eGFR < 60 mL/min/1.73 m2, is 11.2% in our study. By multivariate linear regression analyses, we found that salivary conductivity was positively related to age and fasting glucose but negatively associated with eGFR. We further divided subjects into low, medium, and high groups according to the tertials of salivary conductivity levels. There was a significant trend for an increment of CKD patients from low to high salivary conductivity groups (4.2% vs. 12.5% vs. 16.9%, p for trend: 0.016). The receiver operating characteristic (ROC) curves disclosed an excellent performance by using salivary conductivity combined with age, gender, and body weight to diagnose CKD (AUC equal to 0.8). The adjusted odds ratio of CKD is 2.66 (95% CI, 1.10−6.46) in subjects with high salivary conductivity levels. Overall, salivary conductivity can serve as a good surrogate marker of kidney function; this real-time, non-invasive, and easy-to-use portable biosensing device may be a reliable tool for screening CKD.
慢性肾脏病(CKD)的患病率正在上升,给医疗保健带来了巨大的负担。传统的肾功能测量需要进行有创的血液检查,这阻碍了早期发现,导致人们对 CKD 的认识较低。我们最近设计了一种使用微型共面生物感应探头的设备,用于测量非常小体积(50 μL)的唾液电导率。我们的初步数据发现,CKD 患者的唾液电导率明显更高。这项横断面研究旨在验证唾液电导率与肾脏功能(以估计肾小球滤过率(eGFR)表示)之间的关系。我们招募了 214 名平均年龄为 63.96±13.53 岁的成年参与者,其中 33.2%为男性。本研究中 CKD 的患病率定义为 eGFR<60mL/min/1.73m2,为 11.2%。通过多元线性回归分析,我们发现唾液电导率与年龄和空腹血糖呈正相关,与 eGFR 呈负相关。我们进一步根据唾液电导率水平的三分位数将受试者分为低、中、高组。从低到高唾液电导率组,CKD 患者的比例呈显著递增趋势(4.2%、12.5%和 16.9%,趋势检验 p 值:0.016)。接受者操作特征(ROC)曲线显示,使用唾液电导率结合年龄、性别和体重来诊断 CKD 的性能优异(AUC 等于 0.8)。高唾液电导率组的 CKD 调整比值比为 2.66(95%CI,1.10-6.46)。总的来说,唾液电导率可以作为肾功能的良好替代标志物;这种实时、非侵入性、易于使用的便携式生物感应设备可能是筛查 CKD 的可靠工具。