Glucose-6-Phosphate Dehydrogenase (G-6-PD) Status and Kidney Functions Evaluation in Patients with Acute Kidney Injury in Two Tertiary Hospitals, Sokoto

Abstract

Background: Glucose-6-phosphate dehydrogenase deficiency has been implicated in the pathogenesis of a number of common diseases, including acute kidney injury. G6PD deficient individuals are prone to developing acute kidney injury if exposed to certain medication, food or infection. There is high prevalence of G6PD deficiency in Sokoto. Aim: To determine the G6PD status and evaluate kidney function in patients with acute kidney injury (AKI). Methodology: This was a case control study involving 206 participants comprising of 106 patients with acute kidney injury and 100 apparently healthy control subjects. The AKI patients were grouped into two; group A: AKI patients with G6PD deficiency, and group B: AKI patients with normal G6PD status. Their blood samples were collected and G6PD status determined by methaemoglobin reduction method, full blood count using Sysmex auto analyser, electrolytes by Ion Selective Electrode, cystatin C by ELISA technique, urea, creatinine and bilirubin using Diacetyl monoxime, Jaffe and Diazo methods respectively. Results: G6PD deficiency was established in patients with acute kidney injury. The values of Cystatin C, microalbumin, creatinine, urea were significantly higher in AKI patients compared with control, their values were higher in AKI patients with G6PD deficiency. There was no significant difference in bilirubin, and electrolytes values between the patients and control with the exception of bicarbonate which was significantly lower in the patients than the control. Haematocrit was lower while white cell count was higher in the patients than in the control. Conclusion: AKI patients with G6PD deficiency had impaired kidney function profiles which was more pronounced than in AKI with normal G6PD status. Since it is recognized that certain medications can precipitate AKI, and because of high G6PD prevalence, there is need for G6PD screening before commencement of drug to patient whose G6PD is unknown.