Subscribe Now Subscribe Today
Research Article
 

Relationship Between ABO Blood Group and Renal Disease Patients Attending Dee Medical Centre, Bukuru, Jos, Plateau State, Nigeria



E.C. Onuoha, E.M. Ike, B.O. Eledo, F.E. Hallie, T.A. Diepreye, O.A. Adaka, L.A. Osuji, F.K. Edeh and N. Nelson-Ebimie
 
Facebook Twitter Digg Reddit Linkedin StumbleUpon E-mail
ABSTRACT

Background and Objective: Acute renal failure is a disorder with a feature of high urea and creatinine level with the outcome of an unexpected decrease in kidney function resulting in a significant decline in glomerular filtration rate. Apart from the major clinical importance of ABO blood group on blood transfusion and organ transplantation, there seem to be strong associations between blood group types and some diseases as a result of the carbohydrates compound found on the surface of the red blood cell membrane. This study aims to determine the effect of ABO blood group on acute renal disease patients. Materials and Methods: This case study was conducted on 56 patients with acute renal failure attending DEE Medical Center, Bukuru, Jos and Plateau State Nigeria from January-September, 2019. Ethical approval and patient consent statements were taken from everyone and the study was performed in the Medical Laboratory department of the hospital. Total 3 mL of patient blood was put into plain bottles. Serum was used to the determine level of urea and creatinine and ABO blood group was done with red cell samples by tube agglutination method. The data obtained were analyzed by SPSS software version 22. Results: Generally, the study revealed a strong association of ABO blood group on acute renal failure (p<0.001). However, Group B antigen was statistically discovered to cause the severity of acute renal failure (p<0.05). Conclusion: The results showed that blood group B individuals are more susceptible and suffer severely in renal disease than other blood group individuals as a result of the presence of D-galactose on its cell membrane.

Services
Related Articles in ASCI
Similar Articles in this Journal
Search in Google Scholar
View Citation
Report Citation

 
  How to cite this article:

E.C. Onuoha, E.M. Ike, B.O. Eledo, F.E. Hallie, T.A. Diepreye, O.A. Adaka, L.A. Osuji, F.K. Edeh and N. Nelson-Ebimie, 2021. Relationship Between ABO Blood Group and Renal Disease Patients Attending Dee Medical Centre, Bukuru, Jos, Plateau State, Nigeria. Asian Journal of Scientific Research, 14: 1-5.

DOI: 10.3923/ajsr.2021.1.5

URL: https://scialert.net/abstract/?doi=ajsr.2021.1.5
 
Copyright: © 2021. This is an open access article distributed under the terms of the creative commons attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.

INTRODUCTION

The most essential blood groups in medical practice are ABO blood group systems1. It was described by Landsteiner in 1900 and forms the major foundation of blood banking and modern transfusion medicine2. ABO blood groups are classified based on the presence or absence of A and B surface antigens into four types namely: A, B, AB and O. The frequency of these four major ABO blood groups differs across various ethnic, geographic and socioeconomic groups3,4. The variations of glycoprotein and glycolipids antigens present on red blood cells determine ABO blood groups5,6. They were indicated by the expression of the carbohydrate antigens A and B on the erythrocyte membrane and blood plasma regular antibodies (anti-A, anti-B)7. These carbohydrate sugars are N-acetylgalactosamine for the A antigen and D-galactose for the B antigen while N-acetylgalactosamine and D-galactose for the blood type AB and absent for the phenotype O. The A, B and AB-related carbohydrate sugars are located on the H antigen and the unmodified H antigen explains the blood group O. The A and B alleles encode a specific glycosyl-transferring enzyme8.

When the kidney is unable to remove the toxic substance and metabolic waste from the blood, it is called renal failure or disease. Acute and chronic are two types of renal failure9. Acute renal failure being our major focus is a disorder with a feature of high urea and creatinine level with the outcome of an unexpected decrease in kidney function resulting in significant decline in glomerular filtration rate10,11. The diagnostic yardstick is the laboratory analysis that shows high serumcreatinine or Blood Urea Nitrogen (BUN) levels11. Advanced age, male gender, African American ethnicity and diabetes mellitus are risk factors11,12. For more understanding, Acute Renal Failure (ARF) is classified into origins of kidney injury namely: pre-renal, intrinsic and post-renal. Pre-renal ARF is the limitation of blood flow to the kidney with frequent symptoms of vomiting, diarrhea, poor fluid intake, fever, use of diuretics and heart failure. Intrinsic ARF occurs by destroying kidney tubules, interstitium and glomeruli. Post renal ARF is due to blockage of one or both urinary tracts. For surgical patients, ARF is a scourging clinical problem with a high rate of mortality based on the fundamental of the disease13.

ABO antigens or carbohydrate (N-acetylgalactosamine and D-galactose) are assumed to be situated on the arterial and venal renal vascular endothelium, peritubular and glomerular capillaries and the epithelial cells of the convoluted tubules and collecting ducts in the kidney6,14. In as much as the major focus of ABO blood group are on compatibility both for blood transfusion and organ transplantation15 however, various studies have made an effort to show associations between blood group types and some diseases including gastric cancer, duodenal ulcers, real failure etc16. Some researchers had indicated facts that these blood group antigens may serve as receptors for infectious disease agents and host inflammatory response5,15,17,18.

This research is intended to determine the effect of ABO blood group on acute renal disease patients in middle belt Nigeria to establish associations between ARF and blood group types among this sector. We hypothesize that the degree of acute renal disease is independent of ABO blood group. Testing the hypothesis with p<0.05 (α = 0.05).

MATERIALS AND METHODS

Study area: This case study was conducted on 56 patients with acute renal failure attending DEE Medical Center, Buruku, Jos and Plateau State Nigeria from January-September, 2019.

Ethical approval: Ethical approval and patient consent statements were taken from everyone and the study was performed in the Medical Laboratory department of the hospital. At first, all patients with proven acute renal failure were included in the study. During the study, no patient had blood transfusion or dialysis before blood sample collection.

Research protocol: Total 3 mL of patient blood were put into plain bottles. Serum was used to determine the level of urea and creatinine and ABO blood group was done with red cell samples by tube agglutination method.

Statistical analysis: The data obtained were analyzed by SPSS software version 22.

RESULTS

In groups of patients with acute renal disease, Table 1 show that 70% male, 30% female and mean age was 36.32±13.3 years. The average levels of creatinine and BUN in patients with acute renal failure were 547.21±165 Umol L1 and 10.955±1.9 mmol L1, respectively. The most frequent age in this research work was 34 years.

Table 2 shows the effect of ABO blood group on acute renal disease patients indicating highly significantly (p = 0.001) rejecting the null hypothesis stating that the degree of acute renal disease is independent of ABO blood group. Accepting that degree of acute renal disease is dependent on ABO blood group.

Table 1:
Demographic and clinical characteristic of acute renal disease

Table 2:
Cross-tabulation on the effect of ABO blood group on acute renal disease patients
*Mean difference is significant at the 0.05 level

Table 3:
Multiple comparisons of different ABO Blood group in Acute Renal disease (creatinine)

Table 4:
Multiple comparisons of different ABO Blood group in Acute Renal disease(Urea)
*Mean difference is significant at the 0.05 level

Table 3 shows multiple comparisons of different ABO Blood groups in Acute Renal disease using creatinine as a marker to identify which particular ABO blood group is responsible for the significant difference using least significant differences (LSD) test between means in an analysis of variance (ANOVA) for the analysis. Blood group B is the cause of significant differences as observed (p = 0.032, 0.003).

Table 4 shows multiple comparisons of different ABO Blood groups in Acute Renal disease using urea as a marker to identify which particular ABO blood group is responsible for the significant difference using Least Significant Differences (LSD) test between means in an analysis of variance (ANOVA) for the analysis. Blood group B is the cause of the significant differences observed (p = 0.042, 0.046).

DISCUSSION

Our finding shows a strong association between acute renal failure and ABO blood group.

ABO blood group has been observed to link with many diseases19. A previous study indicates that blood groups A and O were most commonly associated with renal failure while the AB blood group was least associated8. Another separate study observed A and O blood group antigen subtypes were involved in the progression of immune-mediated Immunoglobulin A nephropathy6. However, these were the contrast of finding where the B blood group was the one associated with acute renal failure.

Reiterating that D-galactose is present in the red blood cell of group B antigen. D-galactose metabolism occurs in the kidney and liver20. It was observed in recent studies that treatment with D-galactose resulted in to increase in oxidative damages of kidney and liver damage thereby leading the rise in Creatinine and Blood Urea Nitrogen levels, increase the severity of the acute renal failure, impaired renal and liver function21-24. Free radicals released by oxidative damage attack essential cell constituents and also induce lipid peroxidation, damage the membranes of cells and organelles in the liver and kidney, cause the swelling and necrosis of hepatocytes and nephrocytes and ultimately result in liver and kidney injury21,25. It can therefore be inferred that D-galactose on the red cell of group B is responsible for the strong association with acute renal failure. We recommend that specific research should be carried out on the effect of D-galactose on renal and liver disease to understanding the mechanism thereof.

CONCLUSION

Our finding shows that blood group B individuals are more susceptible and suffer severely in renal disease than other blood group individuals. We also discovered that D-galactose is responsible for the severity of acute renal failure. It is therefore necessary to ascertain the blood group of renal disease patients not only for a blood transfusion but for the management of the disease. However, the Rh blood group which is another essential blood group system in the medical practice was not included in this research work to determine their effect on renal disease.

SIGNIFICANCE STATEMENT

This study discovered that it can be beneficial to use the therapy that can reduce D-galactose in the management of renal disease patients and such patients should be advised not to take fruits or anything containing D-galactose to fascinate quick recovery. This study will help the researcher to uncover the critical area of renal disease severity that many researchers were not able to explore. Thus, a new theory on these ABO blood group systems on renal disease may be arrived at.

ACKNOWLEDGMENT

Our sincere appreciation to Prof. Dakul, Danaam Anthony, Prof. Matur, Malau Bernard, Prof. Yohanna, Jael Asabe all in Zoology Department, University Of Jos, Plateaus State, Nigeria who supervised the research work. We will not fail to acknowledge Dr. Pam Bulus Dareng, Julia Machan, Ngozi Aniekwe, Titus Gama Luka, Dr. Anthony Thompson and Samuel Odafe Okodhi for their technical support.

REFERENCES
1:  Seeley, R.R., T.D. Stephens and P. Tate, 2008. Anatomy and Physiology. 8th Edn., McGraw-Hill, United State, ISBN: 0071102108 9780071102100 .

2:  Medugu, J.T., U. Abjah, I.A. Nasir, S. Adegoke and E.E. Asuquo, 2016. Distribution of ABO, Rh D blood groups and hemoglobin phenotypes among pregnant women attending a Tertiary Hospital in Yola, Nigeria. J. Med. Trop., 18: 38-42.
CrossRef  |  Direct Link  |  

3:  Zaman, R., M. Parvez, M.D. Jakaria and M.A. Sayeed, 2015. Study of ABO and Rh-D blood group among the common people of Chittagong city corporation area of Bangladesh. J. Public Health Epidemiol., 7: 305-310.
CrossRef  |  Direct Link  |  

4:  Eledo, B.O., D.O. Allagoa, I. Njoku, K.E. Dunga and C.I. Sylvester, 2018. Distribution of haemoglobin variants, ABO blood group and rhesus factor among nursing students of Madonna University Nigeria. MOJ Toxicol., 4: 398-402.
CrossRef  |  Direct Link  |  

5:  Franchini, M. and M.L. Giancarlo, 2013. ABO blood group: Old dogma, new perspectives. Clin. Chem. Lab. Med., 51: 1545-15553.
CrossRef  |  Direct Link  |  

6:  Reilly, J.P., J.A. Brian, S.M. Nilam, D. Tam, D.N. Nguyen et al., 2015. The ABO histo-blood group and AKI in critically Ill patients with trauma or sepsis. Clin. J. Am. Soc. Nephrol., 10: 1911-1920.
CrossRef  |  Direct Link  |  

7:  Clausen, H. and S.I. Hakomori, 1989. ABH and related histo-blood group antigens; immunochemical differences in carrier isotypes and their distribution. Vox Sang., 56: 1-20.
CrossRef  |  Direct Link  |  

8:  O'Donnell, J. and M.A. Laffan, 2001. The relationship between ABO histo-blood group, factor VIII and von Willebrand factor. Transfus Med., 11: 343-351.
CrossRef  |  Direct Link  |  

9:  Prasad, N., S. Barai, S. Gambhir, D. Parasar and M. Ora, 2012. Comparison of glomerular filtration rate estimated by plasma clearance method with modification of diet in renal disease prediction equation and Gates method. Indian J. Nephrol., 22: 103-107.
CrossRef  |  Direct Link  |  

10:  Hilton, R., 2006. Acute renal failure. BMJ, 333: 786-790.
CrossRef  |  Direct Link  |  

11:  Cooper, C.M. and A.Z. Fenves, 2015. Before you call renal: Acute kidney injury for hospitalists. J. Hosp. Med., 10: 403-408.
CrossRef  |  Direct Link  |  

12:  Ishani, A., J.L. Xue, J. Himmelfarb, P.W. Eggers, P.L. Kimmel, B.A. Molitoris and A.J. Collins, 2009. Acute kidney injury increases risk of ESRD among elderly. J. Am. Soc. Nephrol., 20: 223-228.
CrossRef  |  Direct Link  |  

13:  Thadhani, R., M. Pascual and J.V. Bonventre, 1996. Acute renal failure. N. Engl. J. Med., 334: 1448-1460.
CrossRef  |  PubMed  |  Direct Link  |  

14:  Tasaki, M., Y. Yoshida, M. Miyamoto, M. Nameta and L.M. Cuellar et al., 2009. Identification and characterization of major proteins carrying ABO blood group antigens in the human kidney. Transplantation, 87: 1125-1133.
CrossRef  |  Direct Link  |  

15:  Yang, M., X. Jingyuan, O. Yan, Z. Xiaoyan and S. Manman et al., 2017. ABO blood type is associated with renal outcomes in patients with IgA nephropathy. Oncotarget, 26: 73603-73612.
CrossRef  |  Direct Link  |  

16:  Fagherazzi, G., G. Gusto, F. Clavel-Chapelon, B. Balkau and F. Bonnet, 2015. ABO and rhesus blood groups and risk of type 2 diabetes: Evidence from the large E3N cohort study. Diabetologia, 58: 519-522.
CrossRef  |  Direct Link  |  

17:  Liumbruno, G.M. and M. Franchini, 2013. Beyond immunohaematology: The role of the ABO blood group in human diseases. Blood Transfus, 11: 491-499.
Direct Link  |  

18:  Alkout, A.M., C.C. Blackwell and D.M. Weir, 2000. Increased inflammatory responses of persons of blood group O to Helicobacter pylori. J. Infect. Dis., 181: 1364-1369.
Direct Link  |  

19:  Akhtar, K., G. Mehdi, R. Sherwani and L. Sofi, 2010. Relationship between various cancers and ABO blood groups-A Northern India experience. Internet J. Pathol., Vol. 13, No. 1.

20:  Zhang, Z.F., S.H. Fan, Y.L. Zheng, J. Lu, D.M. Wu, Q. Shan and B. Hu, 2009. Purple sweet potato color attenuates oxidative stress and inflammatory response induced by D-galactose in mouse liver. Food Chem. Toxicol., 47: 496-501.
CrossRef  |  Direct Link  |  

21:  Fan, S.H., Z.F. Zhang, Y.L. Zheng, J. Lu and D.M. Wu et al., 2009. Troxerutin protects the mouse kidney from D-galactose-caused injury through anti-inflammation and anti-oxidation. Int. Immunopharmacol., 9: 91-96.

22:  Yu, Y., F. Bai, Y. Liu, Y. Yang and Q. Yuan et al., 2015. Fibroblast growth factor (FGF21) protects mouse liver against d-galactose-induced oxidative stress and apoptosis via activating Nrf2 and PI3K/Akt pathways. Mol. Cell. Biochem., 403: 287-299.
CrossRef  |  Direct Link  |  

23:  Feng, Y., Y. Yu, S. Wang, J. Ren and D. Camer et al., 2016. Chlorogenic acid protects d-galactose-induced liver and kidney injury via antioxidation and anti-inflammation effects in mice. Pharm. Biol., 54: 1027-1034.
CrossRef  |  Direct Link  |  

24:  Liu, C., Hu. Jie, M. Zhi, K. Hongjun and L. Hui et al., 2017. Acute kidney injury and inflammatory response of sepsis following cecal ligation and puncture in d-galactose-induced aging rats. Clin. Interv. Aging., 12: 593-602.
CrossRef  |  Direct Link  |  

25:  Zhang, Z.F., S.H. Fan, Y.L. Zheng, J. Lu, D.M. Wu, Q. Shan and B. Hu, 2009. Troxerutin protects the mouse liver against oxidative stress-mediated injury induced by D-galactose. J. Agric. Food Chem., 57: 7731-7736.
CrossRef  |  Direct Link  |  

©  2021 Science Alert. All Rights Reserved