The Impact of Chronic Kidney Disease on Nutritional Status and Its Possible Relation with Oral Diseases

Abstract

Several studies have demonstrated a strong relation between periodontal diseases and chronic kidney disease (CKD). The main mechanisms at the base of this link are malnutrition, vitamin dysregulation, especially of B-group vitamins and of C and D vitamins, oxidative stress, metabolic acidosis and low-grade inflammation. In particular, in hemodialysis (HD) adult patients, an impairment of nutritional status has been observed, induced not only by the HD procedures themselves, but also due to numerous CKD-related comorbidities. The alteration of nutritional assessment induces systemic manifestations that have repercussions on oral health, like oral microbiota dysbiosis, slow healing of wounds related to hypovitaminosis C, and an alteration of the supporting bone structures of the oral cavity related to metabolic acidosis and vitamin D deficiency. Low-grade inflammation has been observed to characterize periodontal diseases locally and, in a systemic manner, CKD contributes to the amplification of the pathological process, bidirectionally. Therefore, CKD and oral disease patients should be managed by a multidisciplinary professional team that can evaluate the possible co-presence of these two pathological conditions, that negatively influence each other, and set up therapeutic strategies to treat them. Once these patients have been identified, they should be included in a follow-up program, characterized by periodic checks in order to manage these pathological conditions.

Chronic Kidney Disease and Periodontitis Interplay—A Narrative Review

“…Metabolic acidosis is yet another homeostatic imbalance associated to renal disease: usually high anion gap acidosis, due to accumulation of phosphate and sulphate containing acids, is found, but hyperchloremic acidosis due to tubular dysfunction might also contribute; significant acidosis becomes prevalent in stage 4 CKD and is constant in dialysis patients. Long-standing acidosis is known to cause bone loss and might contribute via decreased support of alveolar bone to PO [119].…”

The Utility of Capsicum annuum L. in Internal Medicine and In Dentistry: A Comprehensive Review

“…All of these protein receptors share the same molecular structure, composed of six regions of the transmembrane, forming a non-specific ionic channel [ 14 ]. TRPV1 is the first member of the TRPV subfamily that was discovered by Caterina et al in 1997 [ 15 ]. The authors cloned a receptor that can be activated by Capsaicin, thus, TRPV1 is also known as “Capsaicin receptor” [ 18 ].…”

“…In several clinical studies, the use of Capsaicin has been evaluated in oral rinse formulations with concentrations ranging from 0.025% to 0.075% [ 15 ]. The treatment showed good efficacy, improving BMS symptoms after only 7-day treatment with Capsaicin rinsing.…”

“…Jankovskis et al [ 14 ] reported that oral rinses with 0.02% Capsaicin, associated with vitamin B and zinc oral supplements, can be helpful in patients affected by burning mouth syndrome (BMS) [ 15 , 16 ].…”

Identification of potential crosstalk genes and mechanisms between periodontitis and diabetic nephropathy through bioinformatic analysis

“…[19] Several studies have demonstrated the interaction between periodontitis, diabetes, and chronic kidney disease. [20][21][22][23][24][25] When hyperglycemia, renal injury, and periodontitis coexist, increased inflammatory cytokines, enhanced insulin resistance, and the degree of periodontal inflammation in diabetic patients directly impact glycemic control and the progression of diabetic nephropathy. [26][27][28][29] However, due to the chronic nature of both diseases, influenced by multiple factors and shared risk factors, the precise mechanisms underlying their association remain uncertain.…”