Prevalence and severity of oral disease in adults with chronic kidney disease: a systematic review of observational studies

Ruospo, Marinella; Palmer, Suetonia C.; Craig, Jonathan C.; Gentile, Giorgio; Johnson, David W.; Ford, Pauline; Tonelli, Marcello; Petruzzi, Massimo; Benedittis, M. De; Strippoli, Giovanni F.M.

doi:10.1093/ndt/gft401

Cited by 125 publications

(176 citation statements)

References 104 publications

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“…Alcalinidade salivar e boa CTS são fatores protetores, porém hipofluxo salivar e a dieta cariogênica à qual o indivíduo dialítico é submetido agem de forma desfavorável 8 . Associa-se a esse quadro, a precária higiene oral relatada neste grupo, descrita por Ruospo et al 25 em revisão sistemática, com mais de 11 mil indivíduos dialíticos, revelando que 25% destes nunca escovam os dentes e apenas 11% utilizam o fio dental.…”

Section: Discussionunclassified

Caracterização da saúde bucal de indivíduos renais crônicos aptos a transplante

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Dores

et al. 2015

Rev. odontol. UNESP

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ResumoIntroduçãoA doença renal crônica leva a alterações salivares que interferem na saúde bucal. A imunossupressão no pós-transplante pode facilitar que situações restritas à boca se tornem sistêmicas.ObjetivoCaracterizar a saúde bucal de pacientes renais crônicos aptos a transplante, avaliando fluxo e pH salivar, capacidade tamponante salivar (CTS), lesões estomatológicas, sangramento gengival, cálculo e índice de dentes cariados, perdidos e obturados (CPOD).Material e métodoEstudo transversal, observacional e analítico. Foi coletada saliva não estimulada de 83 voluntários, com hipofluxo salivar caracterizado como < 0,3 mL/min. O pH salivar foi mensurado por fita e considerado alcalino quando > 7. A CTS foi avaliada pela Técnica de Ericsson. Um único examinador calibrado procedeu às avaliações clínicas. Foram utilizados Teste Exato de Fisher, ANOVA e Regressão Linear, com nível de significância de 0,05 e Intervalo de Confiança de 95%.ResultadoHipofluxo salivar esteve presente em 61% da amostra e foi influenciado pelo ganho hídrico interdialítico (p=0,01). A presença de pH salivar alcalino foi influenciada pela ureia sérica (p<0,01) e pela hiperfosfatemia (p=0,01). A CTS foi ótima em 92% e sofreu influência do pH salivar (p=0,02). Três indivíduos apresentaram lesões estomatológicas infecciosas. Sangramento gengival esteve presente em 55%, cálculo em 94% e cárie em 88%. O índice CPOD da amostra foi 17,9 ± 7,48.ConclusãoA saúde bucal dos voluntários foi considerada precária e esse agravo pode se tornar mais maléfico se esses indivíduos forem transplantados. Salienta-se a importância da inserção do Dentista na equipe que assiste o renal crônico.

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Section: Discussionunclassified

Caracterização da saúde bucal de indivíduos renais crônicos aptos a transplante

Lacerda

Viana

Dores

et al. 2015

Rev. odontol. UNESP

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“…This includes catheter-related bloodstream infections, access site infections, thrombosed IV fistulas and grafts, and episodes of peritonitis in PD patients [45]. Oral disease is common in patients with CKD [46], and chronic periodontal inflammation is associated with systemic elevation of inflammatory biomarkers in HD patients and adversely affects patients' survival [47,48]. …”

Section: Etiology Of Inflammation In Ckdmentioning

confidence: 99%

Update on Inflammation in Chronic Kidney Disease

2015

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Background: Despite recent advances in chronic kidney disease (CKD) and end-stage renal disease (ESRD) management, morbidity and mortality in this population remain exceptionally high. Persistent, low-grade inflammation has been recognized as an important component of CKD, playing a unique role in its pathophysiology and being accountable in part for cardiovascular and all-cause mortality, as well as contributing to the development of protein-energy wasting. Summary: The variety of factors contribute to chronic inflammatory status in CKD, including increased production and decreased clearance of pro-inflammatory cytokines, oxidative stress and acidosis, chronic and recurrent infections, including those related to dialysis access, altered metabolism of adipose tissue, and intestinal dysbiosis. Inflammation directly correlates with the glomerular filtration rate (GFR) in CKD and culminates in dialysis patients, where extracorporeal factors, such as impurities in dialysis water, microbiological quality of the dialysate, and bioincompatible factors in the dialysis circuit play an additional role. Genetic and epigenetic influences contributing to inflammatory activation in CKD are currently being intensively investigated. A number of interventions have been proposed to target inflammation in CKD, including lifestyle modifications, pharmacological agents, and optimization of dialysis. Importantly, some of these therapies have been recently tested in randomized controlled trials. Key Messages: Chronic inflammation should be regarded as a common comorbid condition in CKD and especially in dialysis patients. A number of interventions have been proven to be safe and effective in well-designed clinical studies. This includes such inexpensive approaches as modification of physical activity and dietary supplementation. Further investigations are needed to evaluate the effects of these interventions on hard outcomes, as well as to better understand the role of inflammation in selected CKD populations (e.g., in children).

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“…8,9 The possible causes include the following: tissue reactions to toxins or to uratemic catabolites; the hydrolyzing action of the oral bacterial flora on the urea that results in the formation of irritant ammonium compounds; and hemorrhagic diathesis, which is common manifestation of uratemic syndromes. 10 A small local hemorrhage in the oral cavity can cause tissue dystrophy, which is a condition that is predisposing to the development of bacterial infection. Bacterial infection in combination with immune uratemic deficiency can cause ulcerations and the formation of pseudomembranes.…”

Section: Uratemic Stomatitismentioning

confidence: 99%

Oral manifestations in chronic uremia patients

et al. 2015

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The incidence of chronic renal failure (CRF) is approximately 200 cases per million people in different Western countries. Recent data indicate that the incidences of these pathologies are increasing. Ninety percent of patients with CRF report oral signs and symptoms that affect both the bone and soft tissues. A broad range of lesions may be observed in chronic uratemia patients, including the following: gingival hyperplasia, enamel hypoplasia, petechiae, gingival bleeding, and others lesions. These patients require various types of treatment ranging from dietary and lifestyle changes to dialysis and kidney transplantation. CRF often leads to multiple oral manifestations that are difficult for dentists to manage. The present study examined the characteristics of this disease, the existing therapeutic options and the relevant considerations for dental professionals.

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Prevalence and severity of oral disease in adults with chronic kidney disease: a systematic review of observational studies

Abstract: Oral disease is common in adults with CKD, potentially reflects low use of preventative dental services, and may be an important determinant of health in this clinical setting.

Cited by 125 publications

References 104 publications

Caracterização da saúde bucal de indivíduos renais crônicos aptos a transplante

Caracterização da saúde bucal de indivíduos renais crônicos aptos a transplante

Update on Inflammation in Chronic Kidney Disease

Oral manifestations in chronic uremia patients

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