Oral disorders in patients with chronic renal failure. Narrative review.
Abstract
Chronic renal failure (CRF) is one of the best known renal diseases. It is characterized by a deterioration in the overall renal function and is associated with other conditions such as hypertension, diabetes mellitus, uropathy, chronic glomerulonephritis and autoimmune diseases. Patients with CRF show alterations of the masticatory system that are specific to the disease and other type of disorders as a result of treatment. Oral health in dialysis and transplant patients tends to be poor, which makes them more likely to develop pathological conditions in the oral cavity, potentially increasing morbidity, mortality and affecting the quality of life of patients. Among the lesions we can find dysgeusia, periodontitis, candidiasis, gingival bleeding, petechiae, and joint alterations. Gingivitis and xerostomia associated to long-term use medications can cause oral lesions. Children with CRF show two oral conditions of interest: high incidence of dental anomalies and low caries activity. In patients receiving a kidney transplant, previous dental treatment is critical because the immune status of the patient will be affected not only by the toxemia, but by the immunosuppressive drugs used to prevent organ rejection. Therefore, the dentist plays an important role in training parents and/or guardians, doctors and paramedics on the treatment of oral lesions in these patients.
References
1. Dirschnabel AJ, Martins Ade S, Dantas S, Ribas MdeO, Grégio A, Alanis L, Ignacio S, Trevilatto P, Casagrande R, De Lima A, Machado M. Clinical oral findings in dialysis and kidney-transplant patients. Quintessence Int. 2011; 42(2): 127-33.
2. Rebolledo M, Carmona M, Carbonell Z, Díaz A. Salud oral en pacientes con insuficiencia renal crónica hemodializados después de la aplicación de un protocolo estomatológico. Av Odontoestomatol. 2012; 28(2): 77-87.
3. Díaz A, Flores F, Hernández J, Perez C, Celerio C. Alteraciones bucodentales en niños con insuficiencia renal crónica y trasplantes renales. Acta Odontol Venez. 2010; 48(2).
4. Ávila M. Enfermedad renal crónica: prevención y detección temprana en el primer nivel de atención. Med Int Mex. 2013; 29(2):148-53.
5. Souza CM, Braosi A, Luczyszyn S, Casagrande R, Pecoits-Filho R, Riella M, Ignácio S, Trevilatto P. Oral health in Brazilian patients with chronic renal disease. Rev Med Chil. 2008; 136(6):741-6.
6. Lecca MA, Meza J, Ríos K. Manifestaciones bucales en pacientes con insuficiencia renal crónica en hemodiálisis. Rev Estomatol Herediana. 2014; 24(3): 147-54.
7. Cedeño J, Rivas N, Tuliano R. Manifestaciones bucales en pacientes con enfermedad renal crónica terminal bajo tratamiento de hemodiálisis y su manejo en cirugía bucal. VITAE. 2011; 46(1):1-7.
8. Patil S, Khandelwal S, Doni B, Rahman F, Kaswan S. Oral Manifestations in Chronic Renal Failure Patients Attending Two Hospitals in North Karnataka, India. Oral Health Dent Manag. 2012; 11(3): 100-6.
9. 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. 2011; 8(3): 146-51.
10. Souza CM, Braosi AP, Luczyszyn SM, Olandoski M, Kotanko P, Craig RG, Trevilatto PC, Pecoits-Filho R. Association Between Oral Health Parameters, Periodontitis and its Treatment and Mortality in Hemodialysis Patients. J Periodontol. 2014; 85(6): 169-78.
11. Zúñiga C, Müller H, Flores M. Prevalence of chronic kidney disease in subjects consulting in urban primary care clinics. Rev Med Chile. 2011; 139: 1176-84.
12. King E. Dental management of patients in end stage renal failure on dialysis. J Mich Dent Assoc. 2013; 95(9): 42-5, 74.
13. Sekiguchi R, Pannuti C, Silva H. Medina-Pestana J, Romito G. Decrease in oral health may be associated with length of time since beginning dialysis. Spec Care Dentist. 2012; 32(1): 6-10.
14. Parkar SM, Ajuthkrishnan C. Periodontal status in patient undergoing hemodialysis. Indian J nephrol 2012; 22: 246-50.
15. Gupta M, Gupta M, Abhishek. Oral conditions in renal disorders and treatment considerations - A review for pediatric dentist. Saudi Dent J. 2015; 27(3): 113-9.
16. Strippoli G, Palmer S, Ruospo M, Natale P, Saglimbene V, Craig JC, Pellegrini F, Petruzzi M, De Benedittis M, Ford P, Johnson DW, Celia E, Gelfman R, Leal MR, Torok M, Stroumza P, Bednarek-Skublewska A, Dulawa J, Frantzen L, Ferrari JN, del Castillo D, Hegbrant J, Wollheim C, Gargano L; ORAL-D Investigators. Oral disease in adults treated with hemodialysis: prevalence, predictors, and association with mortality and adverse cardiovascular events: the rationale and design of the ORAL Diseases in hemodialysis (ORAL-D) study, a prospective, multinational, longitudinal, observational, cohort study. BMC Nephrol. 2013; 14: 90.
17. Harambat J, Van Stralen K, Kim J, Tizard E. Epidemiology of chronic kidney diseases in children. Pediatr Nephrol. 2012; 27(3): 363-73.
18. Fletcher J, McDonald S, Alexander SI. Prevalence of genetic renal disease in children. Pediatr Nephrol. 2013; 28(2): 251-6.
19. Game F, Selby N, McIntyre C. Chronic Kidney Disease and the foot in diabetes- is inflammation the missing link?. Nephron Clin Pract. 2013; 6: 36-40.
20. Proctor R, Kuman N, Stein A, Moles D, Porter S. Oral and dental aspects of chronic renal failure. J Dent Res. 2005; 84(3): 199-208.
21. Jover A, Bagán J, Jiménez Y, Poveda R. Dental management in renal failure: patients on dialysis. Med Oral Patot Oral Cir Bucal. 2008; 13 (7): 419-26.
22. López-Pintor RM, Hernández G, de Arriba L, de Andrés A. Comparison of oral lesion prevalence in renal transplant patients under immunosuppressive therapy and healthy controls. Oral Dis. 2010; 16(1): 89-95.
23. Craig R. Interactions between chronic renal disease and periodontal disease. Oral Dis. 2008; 14(1): 1-7.
24. García E, Mondragón A, Irigoyen M, Bustamante C. Oral lesions in a group of kidney transplant patients. Med Oral Patol Oral Cir Bucal. 2005; 10: 196-204.
25. Maĭborodin I, Minikeev I, Kim S, Ragimova T. Oral cavity pathology by renal failure. Stomatologiia (Mosk). 2014; 93(1): 72-9.
26. Dioguardi M, Caloro GA, Troiano G, Giannatempo G, Laino L, Petruzzi M, Lo Muzio L. Oral manifestations in chronic uremia patients. Ren Fail. 2015; 29:1-6.
27. Oyetola E, Owotade F, Agbelusi G, Fatusi O, Sanusi A. Oral findings in chronic kidney disease: implications for management in developing countries. BMC Oral Health. 2015; 15: 24.
28. Acosta M, Bolívar M, Espig C, Coronel V. Hallazgos bucales en niños con enfermedad renal. Acta Odontol Venez. 2013; 51(2).
29. Bouattar T, Chbicheb S, Benamar L, El Wady W, Bayahia R. Dental status in 42 chronically hemodialyzed patients. Rev Stomatol Chir Maxillofac. 2011; 112(1):1-5.
30. Meuwese CL, Stenvinkel P, Dekker F. Monitoring of inflammation in patients on dialysis: forewarned is forearmed. Nat Rev Nephrol. 2011; 7: 166-76.
31. Chen LP, Chiang CK, Peng YS. Relationship between periodontal disease and mortality in patients treated with maintenance hemodialysis. Am J Kidney Dis. 2011; 57: 276- 82.
32. Ismail G, Traian H, Dumitriu A, Ismail F. Periodontal Disease: A Covert Source of Inflammation in Chronic Kidney Disease Patient. Int J Nephrol. 2013; 2013: 515796.
33. Yeras M, Hernández M, Lopez J. Estudio epidemiológico de la salud bucodental de los pacientes con enfermedad renal crónica dializados. Medicentro Electrónica. 2004; 8(1): 1- 8.
34. Hamissi J, Porsamimi J, Naseh MR, Mosalaei S. Higiene bucal y el estado periodontal de los pacientes hemodializados con insuficiencia renal crónica en Qazvi, Irán. Este Afr Salud Pública J. 2009 6(1): 108-11.
35. Wilczyńska-Borawska M, Małyszko J, Stokowska W. Oral cavity changes in patients after kidney transplantation and preventive-treatment algorithms. Przegl Lek. 2010; 67(12): 1322-4.
36. Garcez J, Limeres Posse J, Carmona IT, Feijoo JF, Diz Dios P. Oral health status of patients with a mild decrease in glomerular filtration rate. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009; 107(2): 224-8.
37. Güleç AT, Haberal M. Lip and oral mucosal lesions in 100 renal transplant recipients. J Am Acad Dermatol. 2010; 62(1): 96-101.
38. Al-Mohaya MA, Darwazeh AM, Bin-Salih S, Al-Khudair W. Oral lesions in Saudi renal transplant patients. Saudi J Kidney Dis Transpl. 2009; 20(1):20-9.
39. Velazquez N, Orduña C, Brieke W. Insuficiencia renal crónica y sus consideraciones estomatológicas. Rev oral. 2004; 5(16):236-38.
40. Saini R, Sugandha, Saini S. The importance of oral health in kidney diseases. Saudi J Kidney Dis Transpl. 2010; 21(6): 1151-2.
2. Rebolledo M, Carmona M, Carbonell Z, Díaz A. Salud oral en pacientes con insuficiencia renal crónica hemodializados después de la aplicación de un protocolo estomatológico. Av Odontoestomatol. 2012; 28(2): 77-87.
3. Díaz A, Flores F, Hernández J, Perez C, Celerio C. Alteraciones bucodentales en niños con insuficiencia renal crónica y trasplantes renales. Acta Odontol Venez. 2010; 48(2).
4. Ávila M. Enfermedad renal crónica: prevención y detección temprana en el primer nivel de atención. Med Int Mex. 2013; 29(2):148-53.
5. Souza CM, Braosi A, Luczyszyn S, Casagrande R, Pecoits-Filho R, Riella M, Ignácio S, Trevilatto P. Oral health in Brazilian patients with chronic renal disease. Rev Med Chil. 2008; 136(6):741-6.
6. Lecca MA, Meza J, Ríos K. Manifestaciones bucales en pacientes con insuficiencia renal crónica en hemodiálisis. Rev Estomatol Herediana. 2014; 24(3): 147-54.
7. Cedeño J, Rivas N, Tuliano R. Manifestaciones bucales en pacientes con enfermedad renal crónica terminal bajo tratamiento de hemodiálisis y su manejo en cirugía bucal. VITAE. 2011; 46(1):1-7.
8. Patil S, Khandelwal S, Doni B, Rahman F, Kaswan S. Oral Manifestations in Chronic Renal Failure Patients Attending Two Hospitals in North Karnataka, India. Oral Health Dent Manag. 2012; 11(3): 100-6.
9. 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. 2011; 8(3): 146-51.
10. Souza CM, Braosi AP, Luczyszyn SM, Olandoski M, Kotanko P, Craig RG, Trevilatto PC, Pecoits-Filho R. Association Between Oral Health Parameters, Periodontitis and its Treatment and Mortality in Hemodialysis Patients. J Periodontol. 2014; 85(6): 169-78.
11. Zúñiga C, Müller H, Flores M. Prevalence of chronic kidney disease in subjects consulting in urban primary care clinics. Rev Med Chile. 2011; 139: 1176-84.
12. King E. Dental management of patients in end stage renal failure on dialysis. J Mich Dent Assoc. 2013; 95(9): 42-5, 74.
13. Sekiguchi R, Pannuti C, Silva H. Medina-Pestana J, Romito G. Decrease in oral health may be associated with length of time since beginning dialysis. Spec Care Dentist. 2012; 32(1): 6-10.
14. Parkar SM, Ajuthkrishnan C. Periodontal status in patient undergoing hemodialysis. Indian J nephrol 2012; 22: 246-50.
15. Gupta M, Gupta M, Abhishek. Oral conditions in renal disorders and treatment considerations - A review for pediatric dentist. Saudi Dent J. 2015; 27(3): 113-9.
16. Strippoli G, Palmer S, Ruospo M, Natale P, Saglimbene V, Craig JC, Pellegrini F, Petruzzi M, De Benedittis M, Ford P, Johnson DW, Celia E, Gelfman R, Leal MR, Torok M, Stroumza P, Bednarek-Skublewska A, Dulawa J, Frantzen L, Ferrari JN, del Castillo D, Hegbrant J, Wollheim C, Gargano L; ORAL-D Investigators. Oral disease in adults treated with hemodialysis: prevalence, predictors, and association with mortality and adverse cardiovascular events: the rationale and design of the ORAL Diseases in hemodialysis (ORAL-D) study, a prospective, multinational, longitudinal, observational, cohort study. BMC Nephrol. 2013; 14: 90.
17. Harambat J, Van Stralen K, Kim J, Tizard E. Epidemiology of chronic kidney diseases in children. Pediatr Nephrol. 2012; 27(3): 363-73.
18. Fletcher J, McDonald S, Alexander SI. Prevalence of genetic renal disease in children. Pediatr Nephrol. 2013; 28(2): 251-6.
19. Game F, Selby N, McIntyre C. Chronic Kidney Disease and the foot in diabetes- is inflammation the missing link?. Nephron Clin Pract. 2013; 6: 36-40.
20. Proctor R, Kuman N, Stein A, Moles D, Porter S. Oral and dental aspects of chronic renal failure. J Dent Res. 2005; 84(3): 199-208.
21. Jover A, Bagán J, Jiménez Y, Poveda R. Dental management in renal failure: patients on dialysis. Med Oral Patot Oral Cir Bucal. 2008; 13 (7): 419-26.
22. López-Pintor RM, Hernández G, de Arriba L, de Andrés A. Comparison of oral lesion prevalence in renal transplant patients under immunosuppressive therapy and healthy controls. Oral Dis. 2010; 16(1): 89-95.
23. Craig R. Interactions between chronic renal disease and periodontal disease. Oral Dis. 2008; 14(1): 1-7.
24. García E, Mondragón A, Irigoyen M, Bustamante C. Oral lesions in a group of kidney transplant patients. Med Oral Patol Oral Cir Bucal. 2005; 10: 196-204.
25. Maĭborodin I, Minikeev I, Kim S, Ragimova T. Oral cavity pathology by renal failure. Stomatologiia (Mosk). 2014; 93(1): 72-9.
26. Dioguardi M, Caloro GA, Troiano G, Giannatempo G, Laino L, Petruzzi M, Lo Muzio L. Oral manifestations in chronic uremia patients. Ren Fail. 2015; 29:1-6.
27. Oyetola E, Owotade F, Agbelusi G, Fatusi O, Sanusi A. Oral findings in chronic kidney disease: implications for management in developing countries. BMC Oral Health. 2015; 15: 24.
28. Acosta M, Bolívar M, Espig C, Coronel V. Hallazgos bucales en niños con enfermedad renal. Acta Odontol Venez. 2013; 51(2).
29. Bouattar T, Chbicheb S, Benamar L, El Wady W, Bayahia R. Dental status in 42 chronically hemodialyzed patients. Rev Stomatol Chir Maxillofac. 2011; 112(1):1-5.
30. Meuwese CL, Stenvinkel P, Dekker F. Monitoring of inflammation in patients on dialysis: forewarned is forearmed. Nat Rev Nephrol. 2011; 7: 166-76.
31. Chen LP, Chiang CK, Peng YS. Relationship between periodontal disease and mortality in patients treated with maintenance hemodialysis. Am J Kidney Dis. 2011; 57: 276- 82.
32. Ismail G, Traian H, Dumitriu A, Ismail F. Periodontal Disease: A Covert Source of Inflammation in Chronic Kidney Disease Patient. Int J Nephrol. 2013; 2013: 515796.
33. Yeras M, Hernández M, Lopez J. Estudio epidemiológico de la salud bucodental de los pacientes con enfermedad renal crónica dializados. Medicentro Electrónica. 2004; 8(1): 1- 8.
34. Hamissi J, Porsamimi J, Naseh MR, Mosalaei S. Higiene bucal y el estado periodontal de los pacientes hemodializados con insuficiencia renal crónica en Qazvi, Irán. Este Afr Salud Pública J. 2009 6(1): 108-11.
35. Wilczyńska-Borawska M, Małyszko J, Stokowska W. Oral cavity changes in patients after kidney transplantation and preventive-treatment algorithms. Przegl Lek. 2010; 67(12): 1322-4.
36. Garcez J, Limeres Posse J, Carmona IT, Feijoo JF, Diz Dios P. Oral health status of patients with a mild decrease in glomerular filtration rate. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009; 107(2): 224-8.
37. Güleç AT, Haberal M. Lip and oral mucosal lesions in 100 renal transplant recipients. J Am Acad Dermatol. 2010; 62(1): 96-101.
38. Al-Mohaya MA, Darwazeh AM, Bin-Salih S, Al-Khudair W. Oral lesions in Saudi renal transplant patients. Saudi J Kidney Dis Transpl. 2009; 20(1):20-9.
39. Velazquez N, Orduña C, Brieke W. Insuficiencia renal crónica y sus consideraciones estomatológicas. Rev oral. 2004; 5(16):236-38.
40. Saini R, Sugandha, Saini S. The importance of oral health in kidney diseases. Saudi J Kidney Dis Transpl. 2010; 21(6): 1151-2.
Published
2015-12-30
How to Cite
HERNÁNDEZ, Carolina.
Oral disorders in patients with chronic renal failure. Narrative review..
Journal of Oral Research, [S.l.], v. 5, n. 1, p. 27-34, dec. 2015.
ISSN 0719-2479.
Available at: <https://joralres.com/index.php/JOralRes/article/view/joralres.2016.006>. Date accessed: 28 apr. 2024.
doi: https://doi.org/10.17126/joralres.2016.006.
Issue
Section
Reviews
Keywords
Chronic renal failure; oral manifestations; transplantation; dialysis; immunosuppression.
This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. © 2024.
