Abstract
Background: Homeless is worldwide problem, developed and under-developed countries are suffering from, rises leading to health problem, drugs and alcohol related , lack to engage and to medical care, so they develop chronic disorders and that rises morbidity and mortality..
Objective: The aim of this study to evaluate the levels of urea, creatinine, calcium, magnesium and urea/creatinine ratio in homeless individual ,and the effect of the drugs abuse on measured parameters..
Materials and Methods: 50 drugs abuse homeless members were volunteer to assess urea, creatinine, urea /creatinine ratio, calcium and magnesium .In addition 50 healthy controls were involved. Parameters were measured by means of semi – automated chemical analyzer BTS 350, using Biosystem reagents, data obtained analyzed via statistical pakage of social version 22.
Results: The level of serum creatinine and urea was significantly increased in drugs abuse homeless group when compared with reference group (0.56±0.23 mg/dl versus 0.93±0.19) (P 0.5). Also the urea creatinine ratio was significantly higher in drugs abuse homeless group when compare with health control (49.9±29.15 mg/dl versus 24.56±8.77) (P = 0.000).The study illustrated significant decrease in the level of both calcium and magnesium in drugs abuse homeless group when compared with reference group (8.62±0.53mg/dl versus 9.53±0.67.mg/dl p= 0.000, 2.196±0.37mg/dl versus 1.97±0.40 mg/dl p= 0.005 respectively). Across the gender the study deduced significant difference in urea and creatinine levels (male 27.40 ±2.74 mg/dl female 21.11±2.49 mg/dl p =0.002, male 0.97±0.04 female 0.51±0.02mg/dl p= 0.027 respectively) where as there is insignificant difference in calcium and magnesium levels (p ≥ 0.05) in the drugs abuse homless group. Furthermore the levels of creatine and urea were significantly positively correlated with duration of drugs abuse homless (p<0.05), where as calcium and magnesium levels were significantly inversely correlated with duration of drugs abuse homless in the study group(p< 0.05). Across the gender urea and creatinine were significantly differ (p < 0.05) where as there is insignificant difference in calcium and magnesium levels (p > 0.05) in the drugs abuse homless group.
Conclusion: Substances abuse by homeless significantly impairs the renal function and decreased calcium and magnesium levels, so they should be considered as risk factors for kidney injury and osteoporosis among homeless.
Keywords: Drugs Abuse homeless, Urea, Creatinine, calcium. Magnesium. Urea Creatinine Rati.
References
- About homelessness. 2008.
- Amore, K, Baker, M and Howden-Chapman, P (2011) ‘The ETHOS Definition and Classification of Homelessness: An Analysis’, European Journal of Homelessness 5 (2).
- Daly GP. Homeless: policies, strategies, and lives on the street. New York: Routledge; 199
- Hwang S.W., Gogosis E., Chambers C., Dunn J.R., Hoch J.S., Aubry T. Health status, quality of life, residential stability, substance use, and health care utilization among adults applying to a supportive housing program. J. Urban Health. 2011;88:1076–1090. doi: 10.1007/s11524-011-9592-3.
- Moore G., Gerdtz M., Manias E., Hepworth G., Dent A. Socio-demographic and clinical characteristics of re-presentation to an Australian inner-city emergency department: Implications for service delivery. BMC Public Health. 2007;7:32
- Rieke K., Smolsky A., Bock E., Erkes L.P., Porterfield E., Watanabe-Galloway S. Mental and nonmental health hospital admissions among chronically homeless adults before and after supportive housing placement. Soc. Work Public Health. 2015;30:496–503.
- Perth Registry Week 2014—Rough Sleepers Emerging Data. Ruah; Perth, Australia: 2014.
- Victorian Homelessness Strategy Project Team. Drug and alcohol use among those experiencing homelessness. Parity 2001;14(8):37—38. 42
- Zerger S. Substance abuse treatment: what works for homeless people? A review of the literature. Available from: http:// www.nhchc.org/Publications/SubstanceAbuseTreatment LitReview.pdf; 2002 [cited August 27, 2007].
- Krieger J, Higgins DL. Housing and health: Time again for public health action. Am J Public Health 2002;92(5):758—768.
- Plumb JD. Homelessness: Reducing health disparities. Can Med Assoc J 2000;163(2):172—173. 58.
- Joseph Feher, 2017. Quantitative Human Physiology (Second Edition) ch 11.
- Rule AD, Bailey KR, Schwartz GL, et al. For estimating creatinine clearance measuring muscle mass gives better results than those based on demographics. Kidney Int. 2009 May;75(10):1071-8.
- National Institutes of Health (US) Dietary supplement fact sheet: calcium [Internet] Bethesda (MD): National Institutes of Health; 2013.
- Goodman WG, Quarles LD. Development and progression of secondary hyperparathyroidism in chronic kidney disease: lessons from molecular genetics. Kidney Int. 2008;74:276–288.
- Institute of Medicine Standing Committee on the Scientific Evaluation of Dietary Reference Intakes (US) Dietary reference intakes for calcium, phosphorus, magnesium, vitamin D, and fluoride. Washington, D.C.: National Academies Press; 1997.
- Altura BM. Basic biochemistry and physiology of magnesium: a brief review. Mag Tr Ele. 1991;10:167–171.
- Ryan MF. The role of magnesium in clinical biochemistry: an overview. Ann Clin Biochem. 1991;28:19–26.
- Ekramy Elmorsy, Mostafa Abdelsalam, Ahmed Mohamed Abd EL wahab, et al Screening of the adverse effects of Sbstances abuse on Kidney Functions: An Egyptain single center.IJPR.Vol 6.Issuse 1.2016:1-7
- Kanaan Mansoor1, Murad Kheetan1, Saba Shahnawaz2, Anna P. Shapiro3, Eva Patton N. Bramley A. M. E. Easton S. Morley R. P. Snaith etal Systematic review of nephrotoxicity of drugs of abuse, 2005–2016. BMC Nephrology (2017) 18:379
- Nzerue CM, Hewan-Lowe K, Riley LJ. Cocaine and the kidney: a synthesis of pathophysiologic and clinical perspectives. Am J Kidney Dis. 2000;35:783–95.
- Chiuech CC, Kopin IJ. Centrally mediated release by cocaine of endogenous epinephrine and norepinephrine from the sympathoadrenal medullary
- Jaffe JA, Kimmel PL. Chronic nephropathies of cocaine and heroin abuse: a critical review. Clin J Am Soc Nephrol. 2006;1:655–67.
- Isner J, Chokshi S. Cardiovascular complications of cocaine. Curr Probl Cardiol. 1991;16:89–123.
- Zimmerman JL. Cocaine intoxication. Crit Care Clin. 2012;28:517–26.
- Fine DM, Garg N, Haas M, Rahman MH, Lucas GM, Scheel PJ, et al. Cocaine use and hypertensive renal changes in HIV-infected individuals. Clin J Am Soc Nephrol. 2007;2:1125–30.
- Buettner M, Toennes SW, Buettner S, Bickel M, Allwinn R, Geiger H, et al.Nephropathy in illicit drug abusers: a postmortem analysis. Am J Kidney Dis Elsevier Inc. 2014;63:945–53.
- Heesch C, Wilhelm C, Ristich J, Adnane J, Bontempo F, Wagner W. Cocaineactivates platelets and increases the formation of circulating platelet containing micro aggregates in humans. Heart. 2000;83(6):688-695.doi:10.1136 /heart.83.6.688.
- Stark J. Interpretation of BUN and serum creatinine. An interactive exercise. Crit Care NursClin North Am.,10(4), 1998, 491-6.
- Sharea Ijazr, Joni Jackson, Helen Thorley, Katie Porter, Clare Fleming, Alison Richards Adrian Bonner and Jelena Savović.
Corresponding Author
Abdelmula Mohammed Abdalla
Department of Clinical Chemistry, Faculty of Medical Laboratory Sciences
Alneelien University – Khartoum, Sudan
DOI: https://dx.doi.org/10.18535/jmscr/v6i11.62
