


































Food Science and Nutrition Studies 

ISSN 2573-1661 (Print) ISSN 2573-167X (Online) 

Vol. 5, No. 1, 2021 

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Original Paper 

Prevention of Kidneys Failure in Patients with Heart Diseases at 

Cardiology Institut of Abidjan 

ANVOH Koutoua Yves Blanchard1,2*, NIABA Koffi Pierre Valery3, Kouadio Larissa Adjoua4 & 

Kouadio Amani Ange Beryl1 

1 Department of Science of food and Technologies Nangui Abrogoua University, 02 BP 801 Abidjan 02, 

Côte d’Ivoire 

2 Cardiology Institute of Abidjan, Bpv 206 Abidjan, Côte d’Ivoire 

3 Agro-valorization Laboratory, Agro forestry Department, Jean Lorougnon GUEDE University, Daloa, 

Côte d’Ivoire 

4 Department Felix Houphouet Boigny University, Côte d’Ivoire 

* Corresponding author, E-mail: akybcr6@gmail.com 

 

Abstract 

The prevalence of chronic kidney disease (CKD) is high and it is gradually increasing. Arterial 

hypertension accelerates many forms of renal disease and hastens the progression to ESRD. Patients 

with heart diseases with medication have not enough knowledge about the diet increasing kidney 

failure risks. Methods: This descriptive study included 42 selected randomly patients with 

cardiovascular complications with hypercreatininemia. Food frequency questionnaire was used. 

Creatininemia and clearance of creatininemia measurement were done. Results: The results of food 

frequency questionnaire shown that patients with higher serum creatinine are those who drink less than 

1,5 liters of water a day and/or those have not a good repartition in water consumption. Patients with 

higher serum creatinine are those who drunk less than 1,5liters of water a day and those (p≤0.5%). 

Then, Meals with frying induced more triglyceride production than meals with sauce (p≤0.5). Among 

beverage, sodas and homemade juices were most consumed respectively at 36.6 and 51.3%. These 

beverages were associated with higher serum creatininemia. After 3 months of nutritional advises, drop 

in serum creatininemia were observed. Conclusion: Lowering serum creatinine involved augmentation 

in water amount consumption and good water consumption establishing. It also recommends Sodas 

and homemade Juice reducing Sodas should be reduce consumption and promoting water drinking.  

Keywords 

Hypercreatininemia, clearance, water volume, water distribution 

 

 



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1. Introduction 

The prevalence of chronic kidney disease (CKD) is high and it is gradually increasing. Estimates of the 

global burden of disease indicate that diseases of the kidney and urinary tract account for 

approximately 830,000 deaths and 18,467,000 disability-adjusted life years annually (Hostetter, 2004). 

There are many causes of these diseases. They varied from chronic diseases such as Diabetes, 

cardiovascular diseases, diet and others. 

Indeed, diabetes has become the single most important cause of ESRD in the United States and Europe 

(Stengel, Billon, van Dijk, Jager, Dekker, & Simpson, 2003). Hypertension and kidney disease are 

closely related. Arterial hypertension accelerates many forms of renal disease and hastens the 

progression to ESRD (Luke, 1999). The influence of certain types of nutrients has been widely studied 

in relation to kidney function. High protein intake may lead to increased intraglomerular pressure and 

glomerular hyperfiltration. This can cause damage to glomerular structure leading to or aggravating 

chronic kidney disease (CKD) (Gang Jee Ko, Yoshitsugu Obi, Amanda R. Tortoricci, & Kamyar 

Kalantar-Zadeh, 2017). High protein diet, usually defined as >1.2 grams of dietary protein per kilogram 

of body weight a day (g/kg/day), is known to induce significant alterations in renal function and kidney 

health (Kalantar-Zadeh, Moore, & Tortorici, 2016). About sugar, authors shown that people who 

regularly consumed one or more sugar-sweetened soft drinks a day had 58% increased risk of 

developing CKD compared to those who did not consume this type of beverage (Cheungpasitporn, 

Thongprayoon, O'Corragain, Edmonds, Kittanamongkolchai, & Erickson, 2014).  

Despite the fact that the influence of certain types of nutrients has been widely studied in relation to 

kidney function and overall health condition of CKD patients, there are few studies on the impact of 

specific diet precisely, the impact of water consumption on their survival. Recent studies have firmly 

established the importance of continuous blood pressure reduction to slow the progression of many 

forms of renal injury, particularly glomerular disease (Agodoa et al., 2001; Peterson et al., 1995).  

The primary objective of this study was to examine real causes of hypercreatininemia in our patients 

under treatment. A second aim was to propose an adequate diet within water consumption to reduce 

kidney diseases. 

 

2. Research Design and Methods 

This study was conducted at Cardiology Institute of Abidjan (Côte d’Ivoire) in 2018. During 4 months, 

dietary trials were proposed to patients with high creatininemia by modification of their habitual diets 

when necessary.  

2.1 Screening Phase  

Forty two (42) volunteers with high creatininemia with average aged about 47.5 ± 79.5 years 

participate to the study. The minimum age was 44 years and the maximum one was 72 years. Their 

creatinine levels varied between 15 and 20 mg/l. These patients with hypercreatininemia were 

non-smoker and no taking medication known to affect lipid metabolism from the clinical practices.  

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2.2 Dietary Interventions 

Recommendations were delivered during one-to-one consultation sessions. Volunteers were asked 

about their habitual diets by answering a questionnaire developed on local foods. Food frequency 

Questionnaire focused on type of breakfast, lunch and dinner were used. It also focused on type of meal, 

number of meal and type of beverage. Diets mistake were then explained and advices were given to 

them during 30 to 45 minutes for changing experimenting. The nutritionist, in consultation with each 

volunteer, drew up meal programs for the study period and patients noted no change from the original 

program. 

The nutritionist gave dietary advice to participant in order to avoid stressful diets. They met 2 weeks 

after the first consultation for the check-up. No portion size was indicated. They had choice among the 

proposed diet at breakfast and lunch, but they should follow strictly the dinner diet day by day. Only 

men were authorised to add 40 g of bread to vegetable soup on Tuesday and Friday when required. It 

was a hypocaloric diet especially in the evening. 

The diet included low saturated fats, and increased in breads (morning and evening), roots tubers, 

vegetables and fish. It also had less red meat and more poultry. The participants were also taught to 

prepare their own meals or not. 

In addition, fruits consumption was studied and limited to one fruits during the study. 

2.3 None Dietary Interventions 

Although exercising was encouraged during 45 minutes, patients were allowed to choose other types of 

moderate-intensity physical activity twice or 3 times a week. 

2.4 Creatininemia and Clearance Control 

Analyses were led each 2 months and half (75 days). First samples were made at T0. Second samples 

were made 75 days later and this date was mentioned T0 then T1 and T2. Plasma levels of 

creatininemia and clearance of creatininemia were measured using automated procedures in Cardiology 

Institute Laboratory.  

2.5 Exclusion Criteria 

Patients with weight higher than 100kg and those who aged more than 75 were not included in this 

study. 

2.6 Statistical Analysis 

The creatinine and creatinine clearance measurements made at each time (T0, T1 and T2) were 

compared in relation to the variation in the volume of water and soda consumed daily. The frequency of 

consumption and the daily distribution of catches in the period concerned. This was achieved by 

various analysis tests (ANOVA) with one / and / or two classification criteria in order to see if there is a 

difference in the evolution of the level of each parameter studied (serum creatinine and creatinine 

clearance). 

The significance of the difference in the means is determined by comparing the probability p associated 

with the Fischer-Senedecor test statistic to the theoretical threshold of α = 0.05. So when P ≤0.05, there 



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is a significant difference between the means. To process all of our data. All statistical tests were 

carried out using R software (R Core Team, Version 3.6.2 and the graphics were carried out on the one 

hand with this same software and on the other hand with Microsoft Excel software. 

 

3. Results  

The results of our study is shown in tables and figures below. 

 

Table 1. Values According to Daily Water Consumption 

Parameters daily water volume Pr(>F) 

 less than 1.5 l up than 1.5 l  

Number (percentage) 27 (64.28%) 15 (35.72%)  

Serum creatinine (mg/l) 18.9 ± 3,73 17.06 ± 1.75 0.01808 

Clearance of creatinine (ml/min) 57.04 ± 13,51 60.32 ± 9.8 0.37043 

 

Table 1 shows the results of the water consumption survey on serum creatinine values and serum 

creatinine clearance. Among the 42 volunteers, 27 of them (64%) of the patients consumed less than a 

liter and a half of water per day compared to 15 others who drank more. People with a summation of 

less than a liter and a half had the highest values 18.9 ± 3.73 mg / l against 17.06 ± 1.75 mg / l the 

others. 

Regarding creatinine clearance, it changes in the opposite direction to creatinine. The lowest values 

57.04 ml / min were observed in patients with low water consumption. Those with water consumption 

above 1.5 L per day had an average clearance value of 60.32 ± 9.8 ml / min. 

 

Table 2. Values According to Daily Water Consumption Plan 

Paramètres Matin et soir toute la journée cure d’eau Pr (>F) 

Effectif 26 (61.91%) 12 (28.57%) 04 (9.52%)  

Créatininémie (mg/l) 19.31 ± 2,86 17.61 ± 4.17 18.25 ± 2.75 0.15540 

Clairance de la 

Créatininémie (ml/min) 

56.55±9.49 62.02±20.75 57.7±10.92 0.77287 

 

The results of serum creatinine and creatinine clearance according to the distribution of water 

consumption are presented in Table 2. It emerges from this survey that patients with morning and 

evening water consumption are in the majority (61.91%) with the highest mean creatinine levels around 

19.31 ± 2.86 mg / l and a clearance of 56.55 ± 9.49 ml / min.  

Patients with kidney problems with a consumption of water distributed throughout the day represent 

28.57% with an average serum creatinine of 17.61 ± 4.17 mg / l. This group presents the critical mean 



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clearances (62.02 ± 20.75 ml / min). Patients who consume water only in the evening represent 16.67% 

with an average serum creatinine of 16.85 ± 2.41 mg / l and an average clearance of 62.02 ± 20.75 ml / 

min. The number of patients taking water cures is the least (9.52%) with an average serum creatinine of 

18.25 ± 2.75 and an average clearance of 57.7 ± 10.92 ml / min. 

The clearance does not vary with the volume of water consumed by the subjects (P> 0.05), it also does 

not vary with the distribution of water consumption during the day (P> 0.05). On the other hand, the 

interaction between the volume of water consumed and its distribution during the day is very 

significant, so the clearance varies (P <0.05). 27 The subjects who have an usual consumption of water 

greater than or equal to a liter and half (1.5L) distributed throughout the day have the highest average 

clearance. 

 

Table 3. Analysis Table of Variance of Serum Creatinine and Clearance According to the Mode of 

Water Consumption 

Parameter Factors of variation 
Parameters of ANOVA 

N F-Value ddl p 

 Amount of water (1)  6.17 1 0.018 

Creatinine Water consumption plan (2) 42 1.86 3 0.155n.s 

 Interaction between (1) et (2)  1.46 3 0.243 n.s 

 Amount of water (1)  0.82 1 0.370n.s 

Clearance of creatinine Water consumption plan (2) 42 0.38 3 0.773 n.s 

 Interaction between (1) et (2 )  8.67 3 0.000206 

(*) : P < 0,05 ; (**) : P< 0,01 ; (***) : P< 0,001 ; n.s : non significatif (P > 0,05) 

 

 

Figure 1. Evolution of Serum Creatinine 



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Figure 1 shows the evolution of serum creatinine during our study. A decrease in serum creatinine is 

observed. After 2 months of diet, the value drops from 18.31 ± 3.26 mg / l to 12.88 ± 1.99 mg / l, a 

decrease of 29.65%. During the second period of dietary monitoring, the drop in blood creatinine level 

is 16.3%, a final value of 10.78 ± 1.52 mg / l. The total decrease is estimated at almost 45.95%. 

 

 

Figure 2. Variation in Creatinine Clearance 

 

During our work, we observe an increase in the clearance value of creatinine. This constant goes from 

its initial value of 57.95 ± 12.25 mg / l to 81.24 ± 18.05 mg / l, an increase 40.18%. During the second 

part of our study, the clearance reached 91.61 ± 24.78, an increase of 12.51%. The total increase is 

estimated at almost 52.69%. (Figure 2) 

 

4. Discussion 

This study analyzed the correlation between water intake and the prevalence of kidney diseases in 

patients with heart diseases with medication. The research focuses on water amount intake and water 

plan establishing within other beverages. 

This study highlights one of the main causes of kidney diseases in patients in cardiology under 

medication. Indeed, the results of the survey showed that 64% of patients with higher serum creatinine 

were used to drink less than a liter and a half of water a day. Studies in humans have shown that 

numerous factors affect fluid intake Availability, ambient temperature, flavor, flavor variety, beverage 

temperature, proximity of the beverage to the person, and even beverage container have all been shown 

to impact intake (WHO, 2004). Water consumption could vary with ageing according to some authors 

(Kim, Shin, & Kim, 2003). For these authors, during ageing, water consumption decreases as a result of 

reduced metabolic activities. Also, some patients unfortunately replace waters by sugar-sweetened 

beverage (homemade juice and Soda) with water consumption reducing. The first mistake by replacing 

water by these beverages is that these sweetened juice have a higher salt content in the form of sodium. 



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The sodium level of these drinks like apple juice sometimes reaches 218.03 ± 0.22% mg/l according to 

(Agbangnan Dossa Cokou Pascal, Ggohaïda Virginie, Bothon Fifa Théomène Diane, Kanfon Rose 

Estelle, Avlessi Félicien, Wotto Dieudonné Valentin, & Sohounhloue Koko Codjo Dominique1, 2018). 

These values are widely higher than those contained in running water (3 to 18mg/l). Recent studies 

have firmly established the importance of continuous blood pressure reduction to slow the progression 

of many forms of renal injury, particularly glomerular disease (Agodoa et al., 2001; Peterson et al., 

1995). Indeed, High dietary sodium is an important factor influencing blood pressure, predisposing 

patients with established CKD to salt-sensitive hypertension and fluid retention (Carrero & Cozzolino, 

2014; Luik et al., 2002). Renal damage associated with salt intake may be a result of its interaction with 

aldosterone (Lambers Heerspink, Navis, & Ritz, 2012). For these authors, more the blood pressure is 

higher, more renal damage are important.  

On one hand, the first finding of the present study is that the amount of daily intake of water around 

2liters and half revealed very useful to decrease the risk of renal failure by reduce the serum creatinine. 

This finding could be explained by the therapeutic benefits of water drinking on heart activity 

previously shown by several authors (Lu et al., 2003). The mechanism(s) by which water has its 

beneficial effect is unknown. It is known that water evokes a pressor response in patients with 

autonomic failure (Shannon et al.,, 2002) and improves orthostatic responses in the postural tachycardia 

syndrome (Kobayashi, 1957). Water drinking also enhances cardiovagal tone in young healthy subjects 

(Routledge, Chowdhary, Coote, & Townend, 2002). Some authors advocate that water drinking should 

be utilized as an adjunct to other methods of treatment for patients with postural syncope and suggest 

that these patients be encouraged to drink water (Claydon, Schoeder, Lucy, Norcliffe, & Hainsworth, 

2006). 

Our results are supported by the proposals made in Korea where the 2010 reference nutritional intake 

recommends, for men and women to drink 2.1 and 2.6 L / day and 1.8 and 2.1 L / day, respectively 

(Anonymos 2, 2010). Our results are also similar to that author who suggests drinking 30 ml of water 

per kilogram of weight (Chernoff, 1994). 

On the other hand, beside of the amount of water intake, the main finding of our study was the 

correlation between daily intakes of water plan and clearance of creatinine. Our study has shown a 

significant decrease of clearance of creatinine when the daily consumption was spread over the whole 

day on 5 intakes. 

 

5. Conclusion 

Our study showed that there is now substantial evidence that lower water intake increases the risk of 

kidney diseases by increasing the serum creatinine level in patients with heart diseases with under 

medication. Dietary interventions have proven effective in reducing the risk of developing kidney by 

reducing serum creatininemia and increasing clearance of creatinine. The identification of risk factors 

can prevent or limit disease through lifestyle modifications. These findings reinforce the need to 



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promote the continuing education for healthcare teams involved in the treatment of these patients, 

sponsoring the prevention and diagnosis of CKD at the early stages.  

 

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