The association between periodontal conditions, inflammation, nutritional status and calcium-phosphate metabolism disorders in hemodialysis patients

Cholewa, Marta; Madziarska, Katarzyna; Radwan-Oczko, Małgorzata

doi:10.1590/1678-7757-2017-0495

Cited by 21 publications

(31 citation statements)

References 28 publications

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“…However, in contrast to these results, there have been several reports indicating that PD patients and healthy individuals show a similar prevalence of periodontitis [7,8]. Surprisingly, a recent report suggested that 106 of 107 HD patients (99.1%) exhibit some form of periodontitis [9], and another study also showed that only one of 103 HD patients evaluated had a healthy periodontium [10]. Even if such reports are excluded, many studies have reported that over half of HD patients exhibit periodontitis [11,12,13,14].…”

Section: Introductionmentioning

confidence: 94%

“…Thus, many studies have investigated the relationships between the prevalence and/or severity of periodontal disease and serum levels of inflammation-related factors in HD patients. Moreover, periodontal disease may also affect nutritional and bone loss parameters in HD patients [10,31]. Based on these reports, several researchers and clinicians have paid special attention to the relationship between periodontal disease and changes in systemic conditions, including inflammation, nutrition, and bone metabolism, resulting from HD.…”

Section: Hemodialysismentioning

confidence: 99%

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Periodontal Disease in Patients Receiving Dialysis

Miyata

Obata

Mochizuki

et al. 2019

IJMS

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Chronic kidney disease (CKD) is characterized by kidney damage with proteinuria, hematuria, and progressive loss of kidney function. The final stage of CKD is known as end-stage renal disease, which usually indicates that approximately 90% of normal renal function is lost, and necessitates renal replacement therapy for survival. The most widespread renal replacement therapy is dialysis, which includes peritoneal dialysis (PD) and hemodialysis (HD). However, despite the development of novel medical instruments and agents, both dialysis procedures have complications and disadvantages, such as cardiovascular disease due to excessive blood fluid and infections caused by impaired immunity. Periodontal disease is chronic inflammation induced by various pathogens and its frequency and severity in patients undergoing dialysis are higher compared to those in healthy individuals. Therefore, several investigators have paid special attention to the impact of periodontal disease on inflammation-, nutrient-, and bone metabolism-related markers; the immune system; and complications in patients undergoing dialysis. Furthermore, the influence of diabetes on the prevalence and severity of manifestations of periodontal disease, and the properties of saliva in HD patients with periodontitis have been reported. Conversely, there are few reviews discussing periodontal disease in patients with dialysis. In this review, we discuss the available studies and review the pathological roles and clinical significance of periodontal disease in patients receiving PD or HD. In addition, this review underlines the importance of oral health and adequate periodontal treatment to maintain quality of life and prolong survival in these patients.

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Section: Introductionmentioning

confidence: 94%

Section: Hemodialysismentioning

confidence: 99%

Periodontal Disease in Patients Receiving Dialysis

Miyata

Obata

Mochizuki

et al. 2019

IJMS

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show abstract

“…The loss of dental tissue due to caries is less prevalent in individuals with CKD than when compared to the general population due to nausea, esophageal regurgitation or induced vomiting (in cases of bulimia nervosa). According to Cholewa [4], although there are inconclusive outcomes regarding the prevalence of caries in hemodialysis patients, most studies describe a high incidence of…”

Section: Discussionmentioning

confidence: 99%

“…Studies shows that the periodontitis in CKD patients was severe, with increased frequency in the presence of perio pathogens and showed in can be, though not always, observed in this group because of the lack of interdisciplinary care for these patients. Studies suggests that the higher prevalence of periodontal diseases was mainly caused by oral hygiene negligence, rather than by chronic uremia [4].…”

Section: Introductionmentioning

confidence: 99%

Multiple Teeth Extractions, Confection and Installation of Total Prostheses in Patients with Renal Insufficiency: Case Report

Souza¹,

Targino²,

Pinto³

et al. 2018

Int J Oral Dent Health

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performed in alternating with hemodialysis. When it is necessary to use antibiotic, analgesic or anti-inflammatory medication, drugs with hepatic metabolism should be used. However, whenever possible, the patient's nephrologist should be contacted for adjustment and choice of medication. Patients with an organ transplant need immunosuppressive drugs to prevent rejection for the rest of their lives. Because of immunosuppression, these patients may develop oral lesions like gingival overgrowth induced by ciclosporin or by calcium channel blockers, or oral candidiasis, viral infections, and malignancies, such as lip cancer. Since patients are susceptible to oral lesions after organ transplantation due to their immunosuppressive or antihypertensive medication, it is important to examine these patients regularly to allow early detection of oral diseases and facilitate proper treatment to avoid major complications [3]. Although there are inconclusive outcomes regarding the prevalence of caries in hemodialysis patients, most studies describe a high incidence of periodontal disease in these patients, where poor oral hygiene with increased deposits of plaque and calculus, identifying the presence of gingival inflammation, deep periodontal pockets, clinical attachment level loss and bone loss [4]. According to Lopes [5], in dental procedures involving bleeding, acetylsalicylic acid should be avoided. It irreversibly inhibits platelet thromboxane, responsible for platelet aggregation. The use of medications

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“…Phosphate metabolism is often dysregulated in chronic kidney disease (CKD), and hyperphosphatemia contributes to patient morbidity and mortality [48]. CKD is often comorbid with cancer [49], and an association of periodontal disease with CKD has been confirmed in observational studies [50,51,52]. As in cancer, it is plausible that the association of periodontal disease with CKD also involves dysregulated phosphate and calcium metabolism, seen in systemic CKD-MBD [53].…”

Section: Chronic Kidney Disease-mineral and Bone Disordermentioning

confidence: 99%

Dysregulated Phosphate Metabolism, Periodontal Disease, and Cancer: Possible Global Health Implications

Brown

2019

Dentistry Journal

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An association between periodontal disease and cancer has been established in recent studies, but no common etiology has been identified in the hopes of reducing the global burden of these non-communicable diseases. This perspective article hypothesizes that the determinant mediating the association of periodontal disease with cancer is dysregulated phosphate metabolism. Phosphate, an essential dietary micronutrient, is dysregulated in chronic kidney disease, and both cancer and periodontal disease are associated with chronic kidney disease. Reviewed evidence includes the association between phosphate toxicity and cancer development, and the association between periodontal disease and chronic kidney disease-mineral and bone disorder includes conditions such as ectopic calcification and bone resorption, which may be indirectly related to periodontal disease. Dental calculus in periodontal disease contains calcium phosphate crystals that are deposited from excess calcium and phosphate in saliva. Alveolar bone resorption may be linked systemically to release of parathyroid hormone in response to hypocalcemia induced by hyperphosphatemia. More research is needed to examine the role of dysregulated phosphate metabolism in periodontal disease.

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The association between periodontal conditions, inflammation, nutritional status and calcium-phosphate metabolism disorders in hemodialysis patients

Cited by 21 publications

References 28 publications

Periodontal Disease in Patients Receiving Dialysis

Periodontal Disease in Patients Receiving Dialysis

Multiple Teeth Extractions, Confection and Installation of Total Prostheses in Patients with Renal Insufficiency: Case Report

Dysregulated Phosphate Metabolism, Periodontal Disease, and Cancer: Possible Global Health Implications

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