scholarly journals Oral symptoms and oral health in patients with chronic kidney disease

2018 ◽  
Vol 66 (2) ◽  
pp. 160-165 ◽  
Author(s):  
Maria Auxiliadora Gomes do NASCIMENTO ◽  
Maria Sueli Marques SOARES ◽  
Eduardo CHIMENOS KÜSTNER ◽  
Dasaiev Monteiro DUTRA ◽  
Raquel Lopes CAVALCANTI

ABSTRACT Objective: Chronic kidney disease is characterized by progressive and irreversible loss of kidney function. The impact of this disease on oral health also presents controversial results. The aim of the study was to determine oral health conditions and oral symptoms of patients with Chronic kidney disease undergoing hemodialysis. Methods: A cross-sectional study on a population with chronic renal failure was performed. Anamnesis and oral examination, decayed, miss and filled teeth (DMFT) index, community periodontal index, simplified oral hygiene index (OHI-S) and gingival index were conducted. Data were processed using SPSS v.s. 20.0 using descriptive statistics and Fischer’s exact test and ANOVA test (p<0.05). Results: 64.9% of all the individuals were male. The mean age was 50.7±14.8 years. 82.4% had symptoms oral while 44.6% had xerostomia and 31.1% dysgeusia. The mean DMFT was 20.49+8.68, the GI was low in 78.4% and the OHI-S was satisfactory in 73%; according to the community periodontal index, the presence of dental calculus occurred in 52.7%, periodontal pockets 41.9% and gingivitis 2.7%. There was a statistically significant association between xerostomia (p=0.017) and number of drugs consumed and between dysgeusia and OHI-S (p=0.011). Conclusion: The results suggest that oral symptoms such as dry mouth and dysgeusia, are common in Chronic kidney disease patients undergoing hemodialysis. Dental calculus and periodontal disease in Chronic kidney disease may be severe even if low amount of biofilm is present. It is important that dentists know the most prevalent oral symptoms in the patient with Chronic kidney disease, as well as knowing that the periodontal condition of this patient should be carefully supervised.

2021 ◽  
Vol 49 (7) ◽  
pp. 030006052110332
Author(s):  
Rocío Violeta Valenzuela-Narváez ◽  
Daniel Raùl Valenzuela-Narváez ◽  
Daniel Alberto Oswaldo Valenzuela-Narváez ◽  
María Elena Córdova-Noel ◽  
Cris Lisseth Mejía-Ruiz ◽  
...  

Objective The aim of this study was to evaluate periodontal disease as a predictor of chronic kidney disease (CKD) stage in older adults. Methods A total of 1159 adults aged 65 to 80 years and diagnosed with periodontal disease and CKD (stages 1, 2, and 3) were randomly selected for a cross-sectional study. Periodontal status was assessed using the Community Periodontal Index of Treatment Needs (CPITN) and CKD was staged using the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF-KDOQI) guidelines. Results In patients with stage 1 CKD, the odds ratios (ORs) (95% confidence intervals [CIs]) for CPITN-1, CPITN-2, CPITN-3, and CPITN-4 were 1.13 (0.83–1.55), 1.47 (1.13–1.81), 1, and 1, respectively. In patients with stage 2 CKD, the ORs (95% CIs) for CPITN-1, CPITN-2, CPITN-3, and CPITN-4 were 1.49 (1.14–1.93), 1.37 (1.02–1.78), 3.07 (2.81–3.25), and 3.65 (3.49–3.71), respectively. In patients with stage 3 CKD, the ORs (95% CIs) for CPITN-1, CPITN-2, CPITN-3, and CPITN-4 were 1, 1, 4.61 (4.47–5.21), and 5.23 (5.14–5.47), respectively. Conclusion The highest CPITN values (CPITN-3 and CPITN-4) were associated with CKD stages 2 and 3. Thus, periodontal disease may be associated with progression of CKD.


Author(s):  
TAOPHEEQ MUSTAPHA ◽  
VARIJA BHOGIREDDY ◽  
HARTMAN MADU ◽  
ADU BOACHIE ◽  
ABDUL OSENI ◽  
...  

BACKGROUND: Heart failure (HF) and Chronic kidney disease (CKD) are major public health problems that often co-exist with a resultant high mortality and morbidity. Most of the studies evaluating their reciprocal prognostic impact have focused on mortality in majority populations. There is limited literature on the impact of CKD on HF morbidities in ethnic minorities. AIMS: Our study seeks to compare HF outcomes in patients with or without CKD in an African-American predominant cohort. METHODS: We obtained data from the NGH at Meharry Heart Failure Cohort; a comprehensive retrospective HF database comprised of patient care data (HF admissions, non-HF admissions, and emergency room visits) were assessed from January 2006 to December 2008. The study group consist of 306 subjects with a mean age of 65±15 years. 81% were African-American (AA), 19% Caucasian and 48.5% are females. Following the NKF KDOQI guidelines, 5 stages of CKD were outlined based on GFR. RESULTS: The overall prevalence of CKD in this population is 54.2%. CKD stage 1 was most prevalent with 45.8%, prevalence for stages 2-5 are 21.6%, 18.3%, 9.5% and 4.9% respectively. The comparison of the mean of ER visits, non HF hospitalizations and HF hospitalizations between normal and CKD patients was done using independent t-test and showed no significant difference in the mean number of ER visits (p=0.564), or HF hospitalizations(p=0.235). However, there is a statistically significant difference in the mean number of non -HF hospitalizations between normal and CKD patients (p=0.031). CONCLUSION: This study shows that the prevalence of CKD in this minority -predominant HF cohort is similar to prior studies in majority populations. However, only the non-HF hospitalizations were significantly increased in the CKD group. Future prospective studies will be needed to define the implications of this in the management of HF patients with CKD.


2020 ◽  
Author(s):  
Priyank Patel ◽  
Andrew Frankel

Abstract Background Renin–angiotensin–aldosterone system (RAAS) inhibitors provide significant cardiorenal benefits with improved long-term outcomes for patients. This is most significant for patients receiving maximal RAAS inhibition, but some patients are unable to tolerate this therapy because of hyperkalaemia. Recently published National Institute for Health and Care Excellence (NICE) technology appraisal guidance recommended using sodium zirconium cyclosilicate (SZC) and patiromer for patients with chronic kidney disease (CKD) stage 3b to 5 or heart failure with reduced ejection fraction, who are not taking an optimised dosage of RAAS inhibitor because of hyperkalaemia. Objective Determine the impact of a locally produced guideline on effective implementation of NICE recommendation for use of SZC or patiromer to help maximise inhibition of the renin–angiotensin–aldosterone system within the general nephrology clinic. Methods A local guideline to practically support the implementation of recommendations made by NICE in the chronic use of new potassium binders was produced. One hundred sequential patients in a general nephrology clinic with non-immune chronic kidney disease (CKD 3 to 5) had their electronic records reviewed. Those with an indication for RAAS inhibition were identified. Results Of the 100 consecutive patients audited, 46 were female and 54 were male. The mean age of these patients was 64 and the mean estimated glomerular filtration rate (eGFR) was 33. Sixty-eight patients had an indication for being on RAAS inhibition with only 10 on maximal doses. Of the remaining 58 patients, 26 (45%) were limited by hyperkalaemia. Of these 26 patients, 12 of these patients (46%) had hyperkalaemia associated with an episode of acute kidney injury (AKI). Therefore, 14% of patients attending a general nephrology clinic were identified suitable for SZC and patiromer. Conclusions A significant proportion (14%) of unselected patients attending a general nephrology clinic were not on optimum RAAS inhibition due to hyperkalaemia. These patients would meet the criteria established within a working guideline for the implementation of the chronic use of SZC or patiromer and are likely to attain prognostic long-term benefit by using these new potassium binders to maximise RAAS inhibition. This analysis has implications for renal centres across the UK.


2020 ◽  
Vol 11 (02) ◽  
pp. 250-255
Author(s):  
Vasantmeghna S. Murthy ◽  
Vedant S. Shukla

Abstract Background Executive functions (EFs) are critical to daily life and sensitive to our physiological functioning and emotional states. The number of people living with chronic kidney disease (CKD) on hemodialysis (HD) globally is increasing steadily. We aimed to determine the impact of a single session of HD on EFs in patients with CKD receiving maintenance HD (MHD). Methods This was a quasi-experimental study conducted at the department of psychiatry and dialysis unit of a tertiary hospital. Patients undergoing MHD underwent screening to rule out delirium, using the Confusion Assessment Method prior to EF testing. The tests of EF used were the Trail-Making Test—Part B (TMT-B) and Frontal Assessment Battery (FAB), both of which were administered before and after a session of HD. Statistical tests used were Wilcoxon matched pairs signed ranks test, paired t-test, single sample t-test, and correlation analyses. Results The mean time taken on TMT-B before HD was 195.36 seconds and after HD, 171.1 seconds; difference is significant (p = 0.0001). The mean FAB score was 13.19 before HD and 14.83 after HD; the difference is significant (p < 0.0001). Significant differences were observed on similarities (p = 0.003), lexical fluency (p = 0.02), and go–no go (p = 0.003) subtests of FAB. Mean TMT-B scores before and after HD differed significantly from that of a reference study (reference TMT-B 150.69 seconds), p = 0.0002 and 0.04, respectively. Conclusion We conclude that patients with CKD on MHD, in general, have worse executive cognitive functioning compared with healthy populations. A session of HD results in significant improvement in these functions.


BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e027752
Author(s):  
Hirotaka Ochiai ◽  
Takako Shirasawa ◽  
Takahiko Yoshimoto ◽  
Satsue Nagahama ◽  
Mariko Kobayashi ◽  
...  

ObjectivesWeight gain after 20 years of age is associated with chronic kidney disease (CKD). However, the impact of weight gain on CKD might differ by current obesity status. We investigated the association of the combination of weight gain after 20 years of age and current obesity with CKD among adults in Japan.DesignA cross-sectional study.Setting and participantsWe analysed data from 94 822 adults aged 40–64 years who had an annual health check-up in Japan from April 2013 to March 2014.Primary outcome measureCKD was defined as an estimated glomerular filtration rate <60 mL/min/1.73 m2and/or proteinuria.ResultsBoth weight gain ≥10 kg after 20 years of age plus obesity (OR 2.21, 95% CI 2.07 to 2.36) and weight gain of ≥10 kg plus non-obesity (OR 1.31, 95% CI 1.21 to 1.42) significantly increased the OR for CKD when compared with weight gain <10 kg plus non-obesity in men. In women, weight gain ≥10 kg plus obesity (OR 2.04, 95% CI 1.84 to 2.25) and weight gain ≥10 kg plus non-obesity (OR 1.53, 95% CI 1.36 to 1.72) significantly increased the OR for CKD compared with weight gain <10 kg plus non-obesity. These results persisted even after adjustment for age, lifestyle factors, hypertension, dyslipidaemia and diabetes.ConclusionsWeight gain ≥10 kg after 20 years of age was significantly associated with CKD in both obese and non-obese subjects. Moreover, the influence of weight gain ≥10 kg plus obesity on CKD was greater than that of weight gain ≥10 kg plus non-obesity on CKD. The present study results suggest that it is important to consider weight gain after maturity in both obese and non-obese subjects to prevent CKD among Japanese middle-aged adults.


Author(s):  
Thea Kirana ◽  
Heriandi Sutadi ◽  
Sarworini B Budiardjo

 Objective: The objective of this study is to analyze the differences in dental calculus indices and calcium and phosphate levels in children with chronic kidney disease undergoing hemodialysis (HD) and peritoneal dialysis (PD) therapy.Methods: In this cross-sectional study, 15 children undergoing HD therapy and 15 undergoing PD therapy were subjected to intraoral examination for dental calculus indices. Whole unstimulated saliva samples of all subjects were collected and subjected to calcium and phosphate analysis. Statistical analyses were conducted using the Mann–Whitney and independent t-tests.Results: The dental calculus indices were significantly lower and salivary calcium level was significantly higher in the PD group than those in the HD group (p<0.05). The salivary phosphate level was lower in the PD group (p≥0.05) but without significance.Conclusion: The PD group had lower dental calculus indices and higher salivary calcium level. The higher salivary phosphate levels in the HD group may have contribute to the higher dental calculus indices, probably because phosphate plays an important role in dental calculus formation.


2020 ◽  
Vol 14 (1) ◽  
pp. 101-109
Author(s):  
Indra Maulana ◽  
Iwan Shalahuddin ◽  
Taty Hernawaty

Psychosocial factors: The depression level  in patients with chronic kidney disease maintained on dialysisBackground: Chronic renal failure undergoing hemodialysis therapy in the world is almost 1.5 million people, and in Indonesia there are approximately 0.2 people with chronic renal failure undergoing hemodialysis therapy. The impact of hemodialysis on the physical that will occur in patients become weak tired in living their daily lives, against the psychological impact that will occur on sleep problems, impurity and depression, the impact on social and economic conditions that will occur to patients on social relationships, and on the environment the client will also have an impact on the social environment in which he lives. Therefore hemodialysis therapy will have an impact on the quality of life of patients.Purpose: To determine Psychosocial factors: the depression level  in patients with chronic kidney disease maintained on dialysisMethod: A descriptive correlational study by a cross sectional design approach. The sample used was 40 respondents, data collection techniques using questionnaires and direct observation with results calculated based on the total answers to questions given by respondents with criteria: score <17 = no sign of depression, score 18-24 = mild depression, score 25-34 = moderate depression and a score of 35-51 = severe depression, while the bivariate test used chi-squareResults: There was a relationship among factors such as: age, educational, sex, duration of maintaine of hemodialysis therapy and sleep patterns with the depression level in patients with chronic kidney disease under maintained on dialysis at Garut dr. Slamet Hospital.Conclusion: Health workers (nurses) to provide motivational and therapeutic informing in implementing hemodialysis therapy so that patients are more excited and better understand the importance of hemodialysis and to reduce the level of depression.Keywords: Depression level; Patients; Chronic kidney disease; DialysisPendahuluan: Penyakit gagal ginjal kronik yang menjalani terapi hemodialisis di dunia hampir sekitar 1,5 juta orang, dan di indonesi hampitr sekitar 0,2 jiwa penderita gagal ginjal kronik yang menjalani terapi hemodialisis. Dampak hemodialisis terhadap fisik yang akan terjadi pada pasien menjadi lemah lelah dalam menjalani kehidupan sehari-hari, terhadap psikologis dampak yang akan terjadi pada masalah tidur, kecemasaan dan depresi, dampak terhadap sosial dan ekonomi yang akan terjadi pada pasien pada hubungan sosialnya, dan pada lingkungan klien juga akan berdampak pada sosial lingkungan dimana dia tinggal. Maka dari itu terapi hemodialisis akan berdampak pada kualitas hidup pasien.Tujuan: Mengetahui faktor-faktor yang berhubungan dengan tingkat depresi pada pasien gagal ginjal kronis yang menjalani tindakan HemodialisaMetode: Menggunakan rancangan deskriptif korelasional dengan pendekatan desain cross sectional dengan sampel sebanyak 40 responden, teknik pengambilan data menggunakan kuesioner dan observasi langsung dengan hasil dihitung berdasarkan  total jawaban dari pertanyaan yang diberikan responden dengan kriteri skor <  17 = tidak ada depresi,  skor 18-24 = depresi ringan,  skor 25-34= depresi sedang dan skor 35-51= depresi berat                        sedangkan uji bivariat menggunakan chi-square.Hasil: Menunjukan adanya hubungan antara faktor : usia, pendidikan, jenis kelamin, lamanya periode menjalani terapi hemodialisa dan pola tidur. Semua faktor tersebut sangat  berhubungan dengan tingkat depresi pada pasien gagal ginjal kronik yang menjalani tindakan hemodialisa di Ruang Hemodialisa RSUD dr. Slamet Garut.Simpulan: Petugas kesehatan (perawat) agar memberikan motivasi dan terapeutik informing dalam pelaksanaan terapi hemodialisa agar pasien lebih bersemangat dan lebih memahami pentingnya hemodialisa serta untuk mengurangi tingkat depresi.


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