Oral and Salivary Changes in Patients with Chronic Kidney Disease

Abstract

Introduction. Kidney disease is associated with many abnormalities in the oral health status as well as with alterations in salivary flow and composition. The aim of this study was to evaluate and to correlate oral clinical findings, salivary flow (SF) and salivary pH values in patients with chronic kidney disease (CKD) not yet on hemodyalisis treatment, those undergoing hemodialysis and in kidney transplant recipients. Methods. In a cross-sectional study 90 patients were included. The cohort was composed of three groups: 30 patients with CKD (serum creatinine values under 120 μmol/L-group 1), 30 patients with CKD on hemodialysis (group 2) and 30 kidney transplanted patients (group 3). The control group consisted of 20 healthy individuals. Oral symptoms, signs and lesions: salivary volume, salivary pH and SF of stimulated and unstimulated saliva were evaluated. Results. Among patients with CKD without dialysis treatment inverse relationship was found between uremic fetor, unpleasant taste and unstimulated SF and also between xerostomia and stimulated SF. Negative correlation between thirst and unstimulated salivary flow was found in both groups, patients with CKD on dialysis and kidney transplant group. Furthermore, in kidney-transplant patients a negative correlation was found between petechiae and SF, while in group of patients with CKD on hemodialysis the same negative correlation was registered between uremic fetor and stimulated SF. Conclusions. Salivary flow was significantly lower in hemodialysis patients, while the highest was in the kidney-transplant recipients accompanied with improvement in the other oral clinical findings observed in our study.

Evaluation of the Prevalence of Oral Manifestations and the Related Factors in Hemodialysis Patients at Selected Hospitals of Tehran Province in 2016

“…Of the patients in our study, 10.8% suffered from oral candidiasis (2% pseudomembranous, 8% erythematous, and 0.8% hyperplastic), and no angular cheilitis was observed. This rate was almost similar to the results of studies by Oyetola et al, Belazelkovska et al, Gavaldac C et al and Gautam NR et al (9,22,24,25) Our results differed from the results reported by de la Rosa García et al and Ruospo M, et al (7,26) This difference can be due to different nutrition and different health conditions in these patients.…”

“…(21) Belazelkovska et al, in their study on 30 dialysis patients and 30 renal transplantation patients, reported that 72.22% of the patients showed oral manifestations. (22) The results of these three studies differed from those of our research, which may be due to the studied population, nutritional habits, and the region under study.…”

“…Dialysis also causes xerostomia and delayed wound healing, thus reducing the success of oral treatments. (2,(18)(19)(20)(21)(22)(23)(24)(25)(26) We examined halitosis, oral candidiasis, and oral metallic taste in the current study. Patients with chronic renal disease who require hemodialysis have a lower salivary flow rate as well as suppressed immune systems and are more susceptible to the colonization of opportunistic infections such as candidiasis.…”

Dental condition and salivary characteristics in Vietnamese patients with chronic kidney disease

“…Our results also showed that salivary flow rate significantly decreases as the stage of CKD increased. The results in the present study are in accordance with previous studies of Bayraktar et al 20,22 and Belazelkovska et al 26 This study has certain limitations. A cross-sectional design and convenience sample in the hospital were used thus it is difficult to draw cause and effect conclusions.…”

Quality of life related to oral health of patients undergoing hemodialysis and associated factors

“…Given the chronic uremic state, several alterations frequently occur in the oral cavity among them: uremic stomatitis, gingival hyperplasia, enamel hypoplasia, petechiae and ecchymosis, gingival bleeding, halitosis, increased tartar formation, dental erosion, hyposalivation, xerostomia, angular cheilitis, dysgeusia, and increased incidence of dental caries . These oral alterations can negatively influence the quality of life of patients on hemodialysis treatment …”