Evaluation of Kidney Injury Molecule-1, Creatinine and Urea Levels in Alcohol, Cigarettes, and Polyherbal Medicines (Agbo) Consumers in Nnewi Metropolis, Nigeria

Abstract

“Agbo”, a traditional polyherbal remedy commonly used in Nigeria, is often relied upon for managing illnesses such as malaria, typhoid, and digestive disorders. These mixtures, made from various plant parts, are believed to offer enhanced healing through the combined effects of multiple herbs. However, growing concerns exist about their potential nephrotoxicity, particularly when taken alongside alcohol and cigarettes. These substances, individually known to impair kidney function, may act synergistically to worsen renal stress. This study assesses the impact of polyherbal medicines (Agbo), alcohol, and cigarette use on kidney function by measuring creatinine, urea, and Kidney Injury Molecule-1 (KIM-1) levels. It compares consumers and non-consumers and examines how age, frequency, and duration of use relate to these biomarkers. This is a comparative cross-sectional study involving 102 participants divided into three equal groups comprising 34 individuals each: non-consumers (control), Agbo-alcohol-cigarette consumers (AAC), and alcohol-cigarette consumers (AC). Blood samples were collected and analyzed for serum kidney injury molecule-1 (KIM-1), creatinine, urea, and using ELISA, Jaffe-slot, and Berthelot methods, respectively. Data on age, duration, and frequency of substance use were collected via questionnaires. Statistical analysis, including ANOVA and Pearson correlation, were performed using SPSS version 26, with significance set at p < 0.05 to evaluate differences and relationships across the groups. Results showed that serum levels of creatinine, urea, and KIM-1 differed significantly among the three groups (p < 0.05). Post-hoc analysis revealed that the mean levels of KIM-1, creatinine and urea were significantly higher in ACC group when compared with the control group (p < 0.05). However, only KIM-1 level was significantly higher in AC group when compared with control group (p < 0.05). Creatinine and urea levels did not differ significantly in AC group when compared with control group (p>0.05). Duration of intake and age did not correlate significantly with the KIM-1, creatinine and urea in various groups (p > 0.05). In conclusion, these findings indicate that the combined intake of Agbo, alcohol, or cigarettes may exacerbate kidney dysfunction.