Effects of Catha Edulis (Miraa) on Kidney and Liver Function among Miraa Chewing Adults in Meru County, Kenya

Abstract

Catha edulis (khat) chewing is common in Kenya and it is a daily habit among adults in Meru County. The habit of Catha edulis chewing poses a public health problem. Some studies have been done to investigate the effects of khat on kidney and liver in animals. However, only a few of these studies have been conducted in human. This study was conducted to evaluate the possible effects of Catha edulis on the levels of various bio-chemical parameters to assess kidney and liver function and also compare the effects of red and pale green Catha edulis varieties on adult human consumers from four constitu-encies in Meru County. Ethical review was sought from KNH-UoN ERC. A cross-sectional study was conducted from December 2014 to December 2015 involving 198 chewers and 193 non-chewers consenting adults, aged 18-60 years, who met the inclu-sion criteria were enrolled. Consecutive sampling method was used to recruit partici-pants. A structured questionnaire was used for data collection and blood was drawn from participants. The Humastar 200 automated chemistry analyzer was used to directly determine the values for liver and kidney biochemical parameters while electrolyte i-smart 30 electrolyte analyzer was utilized for electrolytes. The results were computed statistically with SPSS software package version 21. Results were expressed as mean ± SD values, number and percentage values for continuous data. Student t-test was used to compare the different variables between chewers and non-chewers. Comparison between red variety chewers, pale green variety chewers and non-chewers was done using the one way ANOVA test, fol¬lowed by the post-hoc Tukey's test. Comparison between age groups was done using the one way ANOVA test, fol¬lowed by the post-hoc Tukey's test. Cross tabulation was done to determine the proportions of the characteristics of the independent variable. The results showed that majority (96.9%) of the participants were male. Alkaline phosphatase activity was significantly increased in the serum of Catha edulis consumers than non-consumers. TP, DB and Cr concentration were significantly decreased in the serum of Catha edulis consumers than non-consumers. TB, ALA and ALP parameters mean were statistically significantly increased (p<0.05) in red variety chewers than pale green variety chewers. Age and gender did not have significant effect on the level of kidney and liver biochemical parameters in Catha edulis chewers. In con-clusion, liver biochemical parameters were affected in the Catha edulis chewing group which was shown by increasing activity of alkaline phosphatase therefore, Catha edulis might be responsible for liver damage. Catha edulis has no effect on kidney biochemical parameters. Liver biochemical parameters were affected by the red variety Catha edulis chewing as compared to the pale green variety. To shed light on Catha edulis as a cause of liver problem, retrospective and prospective epidemiological studies of chronic miraa users should be initiated and also studies to determine the concentration of cathinone and cathine in different varieties of Catha edulis should be done. CHAPTER