END-STAGE KIDNEY DISEASE AND ORAL HEALTH MEASURES
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Keywords
chronic kidney disease, end-stage renal disease, oral health, xerostomia
Abstract
Background: Chronic Kidney Disease (CKD) is one of the leading causes of worldwide mortality. Oral health among these patients has been found to be poor. Estimates are that oral diseases are present in almost 90% of hemodialysis patients.
Objective: the study aimed to identify the risk factors associated with oral health in ESRD patients, and then form strategies to avoid the modifiable risk factors such as educating patients about the importance of good dental care and encouraging regular dental visits.
Materials and Methodology: A cross-sectional survey was performed at a hospital in Islamabad from Dec 2023 – Feb 2024. All hemodialysis and peritoneal dialysis patients were included. A physician-administered questionnaire was administered to the participants. The data was entered into Microsoft Excel and analyzed. SPSS was used for data analysis.
Results: 54% of patients with CKD had experienced bleeding from gums, 56% patients noticed changes in their oral health after being diagnosed with ESRD, 70% of patients were following specific dietary restrictions related to CKD, 88% of patients were taking supplements for oral health, 56% of patients were also taking medications for xerostomia and other gum related problems. 64% of patients had encountered difficulty accessing dental care due to CKD. Grade 4 or severe tooth recession along with moderate gingivitis was seen in 52% of patients. 10 patients out of 50 also had severe gingivitis. The majority of patients had no knowledge about the use of dental floss.
Conclusion: the study concluded that oral health is poor in ESRD patients due to multiple contributing factors, including the disease process itself, and due to the lack of dental hygiene. Strict preventative measures should be implemented including regular dental visits and the importance of flossing and supplementation for these patients.
References
2. Saran R., Robinson B., Abbott K.C., et al. US Renal Data System 2019 annual data report: epidemiology of kidney disease in the United States. Am J Kidney Dis. 2020;75:A6–A7.
3. GBD Mortality Causes of Death Collaborators Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;385:117–171.
4. Rhee C.M., Kovesdy C.P. Epidemiology: spotlight on CKD deaths-increasing mortality worldwide. Nat Rev Nephrol. 2015;11:199–200.
5. Sullivan JD. End stage renal disease economics and the balance of treatment modalities. Journal of Service Science & Management. 2010;3:45-50
6. Parkar SM, Ajithkrishnan CG. Periodontal status in patients undergoing hemodialysis. Indian Journal of Nephrology. 2012;22(4):246-250
7. Torkzaban P, Arabi R, Kadkhodazadeh M, Moradi J, Khoshhal M. Periodontal status in patients undergoing hemodialysis. Dental Journal of Hamadan University of Medical Sciences. 2009;1(1):7-10
8. Laheij A, Rooijers W, Bidar L, Haidari L, Neradova A, de Vries R, Rozema F. Oral health in patients with end-stage renal disease: A scoping review. Clin Exp Dent Res. 2022 Feb;8(1):54-67. doi: 10.1002/cre2.479. Epub 2021 Aug 29. PMID: 34459147; PMCID: PMC8874082.
9. Jenabian N, Mirsaeed AMG, Ehsani H, Kiakojori A. Periodontal status of patient’ underwent hemodialysis therapy. Caspian Journal of Internal Medicine. 2013;4(2):658-661
10. Jamieson, L. M. , & Thomson, W. M. (2020). Xerostomia: Its prevalence and associations in the adult Australian population. Australian Dental Journal, 65(Suppl 1), S67–s70. 10.1111/adj.12767
11. Bossola, M. (2019). Xerostomia in patients on chronic hemodialysis: An update. Seminars in Dialysis, 32, 467–474. 10.1111/sdi.
12. Costantinides F, Castronovo G, Vettori E, Frattini C, Artero ML, Bevilacqua L, Berton F, Nicolin V, Di Lenarda R. Dental Care for Patients with End-Stage Renal Disease and Undergoing Hemodialysis. Int J Dent. 2018 Nov 13;2018:9610892. doi: 10.1155/2018/9610892. PMID: 30538746; PMCID: PMC6258100
13. Ruospo M., Palmer S. C., Craig J. C., et al. Prevalence and severity of oral disease in adults with chronic kidney disease: a systematic review of observational studies. Nephrology Dialysis Transplantation. 2014;29:364–375. doi: 10.1093/ndt/gft401.
14. Khan NA, Aziz S, Kwiatowsk M, Mirza FA, Haider R, Jamil B. Oral manifesttaions and dental management of patients with chronic renal failure on hemodialysis. J Pak Dent Assoc 2017; 26(4):158-DOI: https://doi.org/10.25301/JPDA.264.15
15. Butt H, khan NR, Jabbar M, Tahir F, Piracha MH, Hafeez F. Association of oral pathologies and deterioration of oral health status in end stage renal disease patientsa admitted in Sharif Medical and Dental College Lahore, Pak J Pathol .2021; 32(1): 17-21
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Dr. Mahvesh Mahmud
Associate Professor Nephrology Watim Medical College, Rawalpindi
Muddasar Pervaiz
MBBS, MPH, Associate Professor in Community Medicine Department, Al-Nafees Medical College, Islamabad
Shafaq Altaf
MBBS FCPS (Internal Medicine), Senior Registrar Watim Medical College, Rawalpindi
Anas Khan Channa
MBB , MPH (Cont'd), Lecturer in Community Medicine Department, Al-Nafees Medical College, Islamabad
Mishaal Hafeez
MBBS, House Officer, Federal General Hospital, Islamabad
Iqra Ibrar
MBBS, House Officer, Federal Journal Hospital, Islamabad