4.4 Article

Discrimination model applied to urinalysis of patients with diabetes and hypertension aiming at diagnosis of chronic kidney disease by Raman spectroscopy

Journal

LASERS IN MEDICAL SCIENCE
Volume 32, Issue 7, Pages 1605-1613

Publisher

SPRINGER LONDON LTD
DOI: 10.1007/s10103-017-2288-5

Keywords

Raman spectroscopy; Mahalanobis distance; Urinalysis; Diabetes; Hypertension; Chronic kidney disease

Funding

  1. public funding agency (Sao Paulo Research Foundation-FAPESP) [2009/01788-5]

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Higher blood pressure level and poor glycemic control in diabetic patients are considered progression factors that cause faster decline in kidney functions leading to kidney damage. The present study aimed to develop a quantification model of biomarkers creatinine, urea, and glucose by means of selected peaks of these compounds, measured by Raman spectroscopy, and to estimate the concentration of these analytes in the urine of normal subjects (G_N), diabetic patients with hypertension (G_WOL) patients with chronic renal failure doing dialysis (G_D). Raman peak intensities at 680 cm(-1) (creatinine), 1004 cm(-1) (urea), and 1128 cm(-1) (glucose) from normal, diabetic, and hypertensive and doing dialysis patients, obtained with a dispersive 830 nm Raman spectrometer, were estimated through Origin software. Spectra of creatinine, urea, and glucose diluted in water were also obtained, and the same peaks were evaluated. A discrimination model based on Mahalanobis distance was developed. It was possible to determine the concentration of creatinine, urea, and glucose by means of the Raman peaks of the selected biomarkers in the urine of the groups G_N, G_WOL, and G_D (r = 0.9). It was shown that the groups G_WOL and G_D had lower creatinine and urea concentrations than the group G_N (p < 0.05). The classification model based on Mahalanobis distance applied to the concentrations of creatinine, urea, and glucose presented a correct classification of 89% for G_N, 86% for G_WOL, and 79% for G_D. It was possible to obtain quantitative information regarding important biomarkers in urine for the assessment of renal impairment in patients with diabetes and hypertension, and this information can be correlated with clinical criteria for the diagnosis of chronic kidney disease.

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