Assessment of oral manifestations of patients with renal failure undergoing hemodialysis by serum and salivary biomarkers

Abstract

Background: Renal failure refers to a condition where the kidneys lose their normal
functionality. Patients with end stage renal disease (ESRD) have to undergo
hemodialysis (HD), With impaired renal function, a decreased glomerular
filtration rate (GFR), and the accumulation and retention of various products of
renal failure, the oral cavity may show a variety of changes as the body progresses
through an azotemic to a uremic state. The general dentist should be able to
recognize these oral symptoms as part of the patient’s systemic disease and not as
an isolated occurrence.
Aims of the study: To evaluate the biochemical properties of the saliva and
Assessment of oral manifestations in patients with chronic renal failure
undergoing hemodialysis.
Patients and methods: Spectrophotometer was used for measuring serum and
salivary calcium, phosphorous, urea and creatinine in thirty three hemodialysis
patients and twenty two control healthy subjects . Salivary PH, Gingival index
and salivary buffering capacity was also recorded.
Results and discussion: All serum and salivary biomarkers (calcium, phosphorous,
urea and creatinine) were significantly changed in hemodialysis patients (calcium
decreased while the others increased).Also salivary PH and buffering capacity
were significantly increased in hemodialysis patients. Gingival index also
increased, and the oral manifestations that was recorded include: dry mouth
(n=21), uremic odor (n=20) , bad taste (n=17) , burning sensation (n=14) , coated
tongue (n=10) ,pale mucosa ( n=5) petechia (n=3), fissured tongue (n=3).
Conclusions: there was differences in salivary parameters between hemodialysis
patients and control group and the salivary variables was correlated too serum
variables , many oral manifestations found to be in hemodialysis patients.