PANCREATIC ENZYMES AS POTENTIAL BIOMARKERS IN MILD TO MODERATE KIDNEY DISEASE: A CASE CONTROL STUDY.

Abstract

Background: Chronic Kidney Disease (CKD) is a progressive condition characterized by declining renal function, leading to significant morbidity and mortality. Early detection is crucial to prevent progression to end-stage renal disease (ESRD). Traditional biomarkers such as serum creatinine and eGFR lack sensitivity in detecting early-stage CKD. Emerging evidence suggests that pancreatic enzymes, including amylase, lipase, and elastase, may serve as novel biomarkers for CKD.
Methods: This case-control study was conducted at the Department of Biochemistry, Krishna Institute of Medical Sciences, Karad, Maharashtra. A total of 40 participants were included, with 20 CKD patients (eGFR 30–89 mL/min/1.73 m²) and 20 healthy controls (eGFR ≥ 90 mL/min/1.73 m²). Serum levels of pancreatic enzymes were measured using colorimetric enzymatic assays and enzyme-linked immunosorbent assay (ELISA). Renal function parameters were assessed using the Jaffe method and CKD-EPI formula. Data were analyzed using SPSS 25.0, with comparisons performed using Student’s t-test and Mann-Whitney U test. ROC curve analysis was conducted to assess diagnostic accuracy, and Pearson’s correlation was used to determine relationships between enzyme levels and eGFR.
Results: Pancreatic enzyme levels were significantly elevated in CKD patients compared to controls (P < 0.001). The mean serum amylase level was 110.5 ± 15.3 U/L in CKD patients versus 65.2 ± 10.4 U/L in controls. Serum lipase was 55.8 ± 8.7 U/L in CKD patients compared to 30.5 ± 5.2 U/L in controls. Elastase showed the most pronounced difference, with 190.2 ± 25.4 ng/mL in CKD patients versus 120.8 ± 15.6 ng/mL in controls. ROC analysis revealed that elastase had the highest diagnostic accuracy (AUC = 0.92, sensitivity = 90%, specificity = 88%). A strong negative correlation was observed between enzyme levels and eGFR (r = -0.86 for elastase, r = -0.82 for lipase, r = -0.78 for amylase; P < 0.001).
Conclusion: This study highlights the potential of pancreatic enzymes, particularly elastase, as early biomarkers for CKD detection. The significant inverse correlation between these enzyme levels and renal function underscores their diagnostic utility. Further research is needed to establish standardized diagnostic thresholds and evaluate their prognostic value in CKD progression.