Assessment of oral and periodontal parameters in patients with end-stage chronic kidney disease

Abstract

SummaryAim: The purpose of the study was to assess the oral cavity status in patients with terminal chronic kidney disease (CKD) undergoing haemodialysis.Materials and Methods: The study comprised 69 patients with end-stage CKD undergoing haemodialysis regime. The data regarding the age, gender, environment, associated diseases were obtained from the clinical medical histories. The patients were submitted to clinical examination, which also included the periodontal probing and the gingival bleeding assessment. The type of edentulous ridge was recorded. Each patient filled a questionnaire offering data regarding the oral hygiene habits, diet, bad habits and the presence/absence of xerostomia.Results and Discussion: The main cause for end-stage CKD was renal, followed by diabetes mellitus and arterial hypertension. The main associated diseases to CKD were clearly secondary arterial hypertension and secondary anaemia; other associated diseases were represented by cardiac diseases, hepatitis, gastro-intestinal diseases, secondary hyperparathyroidism, cirrhosis, hypersplenism, epilepsy and neoplastic diseases. 62.31% of the patients accused frequent xerostomia. When recording the edentulous type, we observed a high percentage of complete tooth loss.Conclusions: There is a close link between the systemic changes in the CKD patient and the oral manifestations. Even 2 of the main causes of CKD (hypertension and diabetes mellitus) exert important changes on the tissues in the oral cavity, leading to significant tooth loss and masticatory impairment, thus, to a poor quality of life.

Periodontal Health of Pre-Dialysis Chronic Kidney Disease Patients in a Northeast Peninsular Malaysia Tertiary Hospital

“…CKD patients are known to be in a state of uraemia due to the limitation or reduction in the ability of the kidney to filter properly, which subsequently causes an increase in the level of toxic substances in the bloodstream. This is accompanied by an altered immune system because of impaired T-and B-lymphocytes, as well as monocytes and macrophages (4), resulting in reduced host response to sub-gingival gram-negative microbial aggression. Uraemia might also be associated with increased prevalence and severity of gingival inflammation and periodontitis, with increased dialysis vintage (4).…”

“…This is accompanied by an altered immune system because of impaired T-and B-lymphocytes, as well as monocytes and macrophages (4), resulting in reduced host response to sub-gingival gram-negative microbial aggression. Uraemia might also be associated with increased prevalence and severity of gingival inflammation and periodontitis, with increased dialysis vintage (4).…”

Oral and Maxillofacial Manifestations of Mineral and Bone Disorders Associated with Chronic Renal Failure

“…In chronic renal failure, a hole range of changes occur in the oral cavity that are associated with CKD itself or with CKD therapy and almost 90% of end stage renal disease patients develop oral signs and symptoms [36][37][38][39]. Apart from the ones related to mineral and bone disorders as exposed in this paper, other oral manifestation connected Table 3 TREATMENT CONSIDERATION AND RECOMMENDATIONS to different complications of CKD may appear, like periodontitis, uraemic odor, xerostomia, mucosal petechia/ ecchimosis or uremic stomatitis [39][40][41].…”