Estimation and Comparative Overview of Serum Fluoride and Renal Parameters in Diabetic Nephropathy

This study estimate and compare Blood Glucose and Fluoride levels within study groups and to correlate serum renal parameters with fluoride among study subjects. Diabetes mellitus (DM) and its microvascular complication; diabetic nephropathy (DN) is documented as a more prevalent disorder in fluoride endemic areas across the world. Kidneys are the major route of excretion of fluoride and are thus the primary organ affected. Fluoride in minor quantities may also be excreted through sweat, saliva and feaces. Though Fluoride in minor quantities (<1.5 ppm) is considered to be essential for dental and bone enamel mineralization which form fluroapetite. Chronic exposure (> 2ppm) is considered to be toxic leading to fluorosis. This study was conducted at Sri R.L. Jalappa Hospital attached to Sri Devaraj Urs Medical College, Constituent of Sri Devaraj Urs Academy of Higher Education and Research, Karnataka, India. Total 90 subjects with the age group 45-75 years of either gender were included. Our results showed that Fasting, post prandial blood glucose values and serum Fluoride were significantly higher (x%;179.27±53.86, 148±41.96,236.50±64.83, 250.43±72.85, 0.63±0.59, 0.52±0.3 p<0.001) in T2DM without CKD group as compared to the controls and T2DM with CKD. Renal profile when compared between three groups Urea, Creatinine and Potassium were significantly higher in T2DM with CKD as compared to controls and T2DM without CKD. We conclude that analysis of serum/ urine fluoride can be preferred for the subjects attending medicine OPD who are at risk, Installing water defluroditation plants at every village as they and livestock are mainly exposed to fluoride, Creating awareness among residents by conducting regular camps and routine medical checkups and Estimate fluoride levels of potable water at regular intervals, which would help decrease its effect among living system. This study also supports the hypothesis of increase serum Fluoride increases DM and DN which is evident from the results as we observed significant increase of serum fluoride in T2DM and DN subject comparecto controls. Evaluation of these parameters may help in early diagnosis and management and may help better patient care and nation as well.