Dental considerations for the patient with renal disease

Dental Care for Patients with End-Stage Renal Disease and Undergoing Hemodialysis

“…GFR is the rate at which an ultrafiltrate of plasma is produced by glomeruli per unit of time and is the best estimate of the number of functioning nephrons or functional renal mass [ 4 ]. Normal GFR values are approximately 120–130 mL/min/1.73 m 2 and vary according to age, gender, and body size [ 5 ]. All individuals with a GFR <60 mL/min/1.73 m 2 for 3 months are classified as having chronic kidney disease, irrespective of the presence or absence of kidney damage.…”

“…A final consideration with respect to pharmacotherapy is that most drugs are at least partially excreted via the kidney. With renal dysfunction, the distribution, metabolism, bioavailability, and rate of excretion of the drug are altered, and an adjustment of the dosage by amount or by frequency is required [ 5 ].…”

“…Primarily, in regard with the mucosal and glandular involvement, the most common oral finding in dialyzed patient is pallor of the mucosa due mainly to anemia (reduced erythropoietin synthesis) [ 5 , 15 ]. Bleeding tendency in these patients is sustained by alterations in platelet aggregation and renal anemia [ 15 , 18 ].…”

“…Bleeding tendency in these patients is sustained by alterations in platelet aggregation and renal anemia [ 15 , 18 ]. Also, hemodialysis predisposes to ecchymoses, petechiae, and hemorrhage in the oral mucosa [ 5 , 19 , 20 ].…”

Oral manifestations consistent with chronic kidney disease

“…Tooth Mobility -possibly a result from kidney osteodystrophy, often seen in patients with kidney failure and as a result of secondary hyperparathyroidism (21,23).…”