Online Program

Early diagnosis of kidney disease: The role of acetaminophen and alcohol consumption, other predispositions

Monday, November 4, 2013 : 9:00 a.m. - 9:10 a.m.

Harrison T. Ndetan, MSc, MPH, DrPH, Research Institute, Parker University, Dallas, TX
Ronald Rupert, MS, DC, Research Institute, Parker University, Dallas, TX
Rani Jayswal, MPH, Parkern University
Background Pain is a common symptom among chiropractic patients and is most frequently self-treated with acetaminophen. We hypothesize that incipient kidney disease (with no clinical manifestation) may develop in subjects with no previous history exposed to therapeutic amounts of acetaminophen in combination with low/moderate amounts of alcohol, particularly those with factors that put them at increased risk of developing acetaminophen toxicity. This study explores the feasibility of detecting very small changes in kidney function potentially associated with the ingestion of therapeutic amounts of acetaminophen in combination with low/moderate amounts of alcohol using urine and blood samples.

Methods Laboratory examination data of the 2003-2004 National Health and Nutrition Examination Survey was analyzed. Exposure variables were therapeutic amount of acetaminophens and light/moderate alcohol while predisposing factors included obesity, diabetes, ingestion of fat, fasting, AIDS, drugs. Outcome variables relating to kidney disease include urine Albumin/Creatinine (Alb/Cr) ratio and Glomerular filtration rate (GFR).

Results A combined ingestion of therapeutic amount of acetaminophen and light/moderate alcohol were significantly related to abnormal levels GFR [OR=7.63(1.6, 36.35)] but not significantly related to Alb/Cr ratio [OR=3.85 (0.35,41.73)]. We will analyze further the effect of other predispositions and at different levels of GFR, Alb/Cr ratios, Serum Creatinine and Blood Urea Nitrogen

Conclusions: Results may help identify threshold values from blood and urine samples indicative of early kidney disease that may contribute towards early diagnosis. Being conscious and able to detect early signs of kidney problem places the DC at a good position to address wellness and primary prevention.

Learning Areas:

Public health or related education
Public health or related research
Social and behavioral sciences

Learning Objectives:
Explain feasibility of detecting small changes in kidney function that is expected to be associated with the ingestion of acetaminophen in combination with alcohol in subjects with predispositions. Describe threshold values of the Glomerular filtration rate and urine Albumin/Creatinine ratio that may be indicative of early kidney disease. Describe how the concomitant presence of light/moderate alcohol and other common factors with therapeutic acetaminophen dose may cause early renal disease.

Keyword(s): Alcohol, Health Promotion

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an associate Professor/Biostatistician, a public health researcher, and an APHA member. I have conducted, presented and published other secondary data analysis.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.