Oral manifestation and salivary changes in renal patients undergoing hemodialysis

Marieh Honarmand, Leila Farhad-Mollashahi, Alireza Nakhaee, Fahimeh Sargolzaie, Marieh Honarmand, Leila Farhad-Mollashahi, Alireza Nakhaee, Fahimeh Sargolzaie

Abstract

Background: Salivary changes in hemodialysis patients may result in various oral manifestations. This research intended to determine oral manifestations and some salivary markers in hemodialysis patients.

Material and methods: This cross-sectional study was conducted on 30 hemodialysis patients (the patient group) and 30 healthy individuals (the control group). Saliva urea and calcium levels and pH values of the participants were measured, and oral manifestations such as pale mucosa, xerostomia, halitosis, changes in the sense of taste, increased calculus formation, gingival bleeding, etc. were recorded in the information collection form. The data was analyzed using T-test and chi-square, and p<0.05 was considered to be significant.

Results: The mean salivary urea level and pH value in the patient group were significantly higher compared to those of the control group (P<0.05), but there were no significant differences between the two groups with respect to salivary calcium. Halitosis, xerostomia, and increased calculus were the most prevalent manifestations, and gum bleeding was the least prevalent among the patients.

Conclusions: Advanced chronic renal insufficiency can increase salivary urea level, pH value, halitosis, xerostomia, and calculus formation, and may cause pale mucosa. Key words:Renal dialysis, biomarkers, oral manifestation, saliva.

Conflict of interest statement

Conflict of interest statement:The authors have declared that no conflict of interest exist.

References

    1. Grassmann A, Gioberge S, Moeller S, Brown G. ESRD patients in 2004: global overview of patient numbers, treatment modalities and associated trends. Nephrol Dial Transplant. 2005;20:2587–93.
    1. Aghighi M, Heidary Rouchi A, Zamyadi M, Mahdavi-Mazdeh M, Rajolani H, Ahrabi S. Dialysis in Iran. Iran J Kidney Dis. 2008;2:11–5.
    1. Nandan RK, Sivapathasundharam B, Sivakumar G. Oral manifestations and analysis of salivary and blood urea levels of patients under going haemo dialysis and kidney transplant. Indian J Dent Res. 2005;16:77–82.
    1. Seethalakshmi C, Koteeswaran D, Chiranjeevi V. Correlation of Serum and Salivary Biochemical Parameters in end Stage Renal Disease Patients UndergoingHemodialysis in Pre and Post-Dialysis State. J Clin Diagn Res. 2014;8:CC12–4.
    1. Seraj B, Ahmadi R, Ramezani N, Mashayekhi A, Ahmadi M. Oro-dental health status and salivary characteristics in children with chronic renal failure. J Dent (Tehran) 2011;8:146–51.
    1. Kaufman E, Lamster IB. The diagnostic applications of saliva – A review. Crit Rev Oral Biol Med. 2002;13:197–212.
    1. Martins C, Siqueira WL, Oliveira E, Nicolau J, Primo LG. Dental calculus formation in children and adolescents undergoing hemodialysis. Pediatr Nephrol. 2012;27:1961–6.
    1. Kaushik A, Reddy SS, Umesh L, Devi BK, Santana N, Rakesh N. Oral and salivary changes among renal patients undergoing hemodialysis: A cross-sectional study. Indian J Nephrol. 2013;23:125–9.
    1. Mansourian A, Manouchehr A, Shirazian S, Moslemi E, Haghpanah G. Comparison of Oral Lesion Prevalence Between Renal Transplant Patients and Dialysis Patients. J Dent (Tehran) 2013;10:487–93.
    1. Amini M, Aghighi M, Masoudkabir F, Zamyadi M, Norouzi S, Rajolani H. Hemodialysis adequacy and treatment in Iranian patients: a national multicenter study. Iran J Kidney Dis. 2011;5:103–9.
    1. Swapna L, Reddy R, Ramesh T, Reddy R, Vijayalaxmi N, Karmakar P. Oral Health Status in Haemodialysis Patients. J Clin Diagn Res. 2013;7:2047–50.
    1. Anuradha B, Katta S, Kode V, Praveena CH, Sathe N, Sandeep N. Oral and salivary changes in patients with chronic kidney disease: a clinical and biochemical study. J Indian Soc Periodontol. 2015;19:297–301.
    1. Davidovich E, Davidovits M, Eidelman E, Schwarz Z, Bimstein E. Pathophysiology, therapy, and oral implications of renal failure in children and adolescents: an update. Pediatr Dent. 2005;27:98–106.
    1. Al Nowaiser A, Roberts GJ, Trompeter RS, Wilson M, Lucas VS. Oral health in children with chronic renal failure. Pediatr Nephrol. 2003;18:39–45.
    1. Patil S, Khaandelwal S, Doni B, Rahuman F, Kaswan S. Oral manifestations in chronic renal failure patients attending two hospitals in North Karnataka, India. Oral Health Dent Manag. 2012;11:100–6.
    1. Brandi L. 1alpha(OH)D3 One-alpha-hydroxy-cholecalciferol--an active vitamin D analog. Clinical studies on prophylaxis and treatment of secondary hyperparathyroidism in uremic patients on chronic dialysis. Dan Med Bull. 2008;55:186–210.
    1. Bossola M, Tazza L. Xerostomia in patients on chronic hemodialysis. Nat Rev Nephrol. 2012;8:176–82.
    1. Bots CP, Poorterman JHG, Brand HS, Kalsbeek H, Van Amerongen BM, Veerman ECI. The oral health status of dentate patients with chronic renal failure undergoing dialysis therapy. Oral Diseases. 2006;12:176–80.
    1. Dawes C. Why does supra gingival calculus form preferentially on the lingual surface of the 6 lower anterior teeth? J Can Dent Assoc. 2006;72:923–6.
    1. Kaw D, Malhotra D. Platelet dysfunction and end-stage renal disease. Semin Dial. 2006;19:317–22.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe