Journal of Nepal Association for Medical Laboratory Sciences P.

11-12

Serum Urea and Creatinine in Diabetic

and non-diabetic Subjects
Sugam Shrestha1, Prajwal Gyawali2, Rojeet Shrestha2, Bibek Poudel2, Manoj Sigdel2,
Prashant Regmi2, Manoranjan Shrestha2, Binod Kumar yadav2*
1

National College for Advanced Learning, Lainchour, Kathmandu

Department of Biochemistry, Institute of Medicine, TU Teaching Hospital, Kathmandu

ABSTRACT
Introduction: Diabetic nephropathy is one of the major causes of chronic renal failure. After many years of
diabetes the delicate filtering system in the kidney becomes gradually destroyed, initially becoming leaky
to larger blood proteins such as albumin which are then lost in the urine. Both serum urea and creatinine
are widely used to assess the function of kidney. This study was conducted to establish relationship of
blood sugar level with urea and creatinine levels, in diabetic and non-diabetic subjects.
Materials and Methods: This study was conducted from 2064-4-4 to 2064-7-1 in pathology department
of Bharosa diagnostic and research centre.103 diabetic samples and 49 control samples were analyzed
for serum urea, creatinine and sugar.
Results: 18 out of 103 diabetes samples have high urea level whereas 11 out of 103 had increased
creatinine level. In control only one sample had high urea value and two had high creatinine level. There
was statistical significant increased in urea level with increased in blood sugar level (p<0.05, 95%CI)
Conclusion: Strong relationship of blood urea level was found with blood sugar level. To monitor the
diabetes patients, estimation of blood urea level along with blood sugar level could be important.
Keywords: Blood glucose, Creatinine, Diabetes mellitus, Urea

Introduction
Diabetic mellitus (DM) is a group of metabolic disorder
of carbohydrate metabolism in which glucose is
underused, producing hyperglycemia. Different
statistics have led to diabetes being described as
one of the main threat to human health in the 21st
century.1 DM is the major cause of renal morbidity
and mortality, and diabetic nephropathy is one of
chronic kidney failure.2
The most common lesions involve the glomeruli
and are associated clinically with three glomerular
syndromes, including non nephritic protienuria,
nephrotic syndrome and chronic renal failure.3
Diabetes nephropathy is the kidney disease that
occurs as a result of diabetes. After many years of
diabetes the delicate filtering system in the kidney
becomes destroyed, initially becoming leaky to larger
blood proteins such as albumin which are then lost in
urine. This is more likely to occur if the blood sugar is
poorly controlled.4

Corresponding author: Binod Kumar Yadav, Assistant Professor,

Department of Biochemistry, Institute of Medicine, TU Teaching Hospital, Maharajgunj, E-mail:-binod3aug@gmail.com

Measurement of the plasma urea and creatinine is

widely regarded as a test of renal function.
The aim of our study is to measure serum urea
and creatinine levels in diabetes and non-diabetic
samples and to establish relationship of blood sugar
level with urea and creatinine levels.

Materials and Methods

This study was conducted from 2064-4-4 to 20647-1 in Pathology Department of Barosha Diagnostic
and Research Centre. 103 diabetic samples were
analyzed within three month period. 49 normal
controls were taken. The main variables under study
were urea, creatinine and blood glucose levels.
Estimation of serum glucose was done by glucose
oxidase and peroxidase method5. Similarly serum urea
was estimated by Berthelots method 6 while creatinine
was estimated by alkaline Jaffes Picrate method 7.

Results
Out of 49 control samples taken, 47 samples had
normal urea level and 48 samples had normal
creatinine level. On the other hand 18 out of 103
diabetes samples had high urea level and 11 out of

JNAMLS I VOL 9 I NO. 1 I December, 2008 11

Sugam Shrestha et al.

103 had increase creatinine level. (Table 1)
Table 1 : comparison of urea and creatinine levels
in controls and cases
Urea level
High
Controls
Cases

Creatinine Level

Normal

High

Normal

47

48

18

85

11

92

The mean ( S.D.) urea level in control group was found

to be 31 9.04 whereas in cases it was found to be 38
14.6. The mean ( S.D) blood sugar in control was
found to be 83 11.5, whereas in cases it was found
to be 179 59.4. The mean (S.D.) creatinine levels in
controls was found to be 0.76 0.27 and in cases it was
found to be 0.95 0.49. (Table 2)
Table 2: mean blood sugar, mean urea and mean creatinine level
in control and cases
Serum
Sample
N
Urea
Blood Sugar
Creatinine
Control
49
30.87 9.04
83.29 11.48
0.76 0.27
Cases

103

38.18 14.55

178.59 59.43

However male showed slightly higher creatinine level

than the females but the p value was not significant.
This result is supported by various researchers who
showed that sex wise variation occurs only in serum
creatinine level but not in blood sugar level and urea
level. High serum creatinine level was seen in males
than females, which could be because of storage of
creatinine as a waste product in muscle mass and
the presence of high muscle mass in males9.

Conclusion
DM is the major cause of renal morbidity and mortality,
and diabetic nephropathy is one of chronic kidney
failure. Blood urea and creatinine is widely accepted
to assess the renal functions. Good control of blood
glucose level is absolute requirement to prevent
progressive renal impairment. In order to monitor the
control of blood glucose level along with blood sugar
blood urea can also be important parameter as we
found that there is strong correlation of blood sugar
and urea level.

0.95 0.49

When this mean value of urea was compared with

mean value of the sugar the p value was found to be
significant (p< 0.05). Whereas when creatinine was
compared with blood sugar p value was not found to be
significant (p= 0.065), which is not less than 0.05.

References
1.

2.

Discussion
The p value of urea and sugar was found to be 0.022
(p< 0.05), while p value of blood sugar and creatinine
comparison was not found to be significant. These
findings revel that there is strong relationship of
blood sugar level with urea level. As there is increase
in blood sugar level an increase in urea level has
been detected. This corroborates with the findings of
Bauza, Mosquera A (2003) that hyperglycemia is one
of the major causes of progressive renal damage.

3.

An increase in urea level is seen when there is damage

to the kidney or the kidney is not functioning properly.
Increment of blood urea level with the increment of blood
sugar level clearly indicates that the increase blood
sugar level causes damage to the kidney. Research
conducted by Anjaneyulu et al 2004 had found that
increase urea and serum creatinine in diabetic rats
indicates progressive renal damage. 8

7.

In our finding sex was not the determining factor for

the diabetes. There was not relationship between sex
and the blood sugar levels like wise significant relation
between sex and urea level was also not observed.

9.

4.
5.

6.

8.

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12 JNAMLS I VOL 9 I NO. 1 I December, 2008