de la Rosa García Estela, Mondragón Padilla Arnoldo, Aranda Romo Saray, Bustamante Ramírez Martha Alicia
Departamento de Atención a la Salud. Universidad Autónoma Metropolitana Xochimilco, Mexico, DF, Mexico.
Med Oral Patol Oral Cir Bucal. 2006 Nov 1;11(6):E467-73.
To assess oral signs, symptoms and oral lesions (OL) type and prevalence, in diabetic patients with end stage renal disease (ESRD DM), and compare them with analogous findings in a non-ESRD DM group; analyze the possible association between oral manifestations, as well as with relevant laboratory findings. Research design. Two adult groups were studied: Group A: ESRD DM on dialysis, and group B: non-ESRD DM (serum creatinine <2.0 mg/dl). Known DM evolution time, dialysis treatment type and duration, and laboratory results were recorded. An oral exam was performed, searching for signs, symptoms and ESRD-associated OL. Associations were analyzed using Chi square, Fisher s exact test, and odds ratios (OR) with 95% confidence intervals. Ages, time on dialysis, and laboratory results were compared with Student s t test.
229 individuals were examined, group A 99, and group B 130 pts. Signs and symptoms prevalence was higher in group A: 77.8% vs. 57.6%, (P<0.001), uremic breath (48.5%), unpleasant taste (45.5%) and xerostomia (44.4%) being the most frequent ones. OL were also more prevalent in group A; 65.6% vs. 36.9% (P<0.001). The most frequent OL were dry, fissured lips (28.3%), saburral tongue (18.2%) and candidiasis (17.2%). No difference was found in candidiasis prevalence between groups. Candidiasis was found associated to xerostomia (P<0.05) and smooth tongue (P<0.05) only in group A.
ESRD DM patients had a significantly higher prevalence of signs, symptoms and OLs, as compared to non-ESRD DM pts. The high prevalence of uremic fetor, xerostomia, saburral tongue and candidiasis in group A, could be tried as warning signs on the possibility of non diagnosed advanced renal disease in other diabetic patients.
评估终末期肾病糖尿病患者（ESRD DM）的口腔体征、症状及口腔损害（OL）类型和患病率，并与非终末期肾病糖尿病组的类似结果进行比较；分析口腔表现之间以及与相关实验室检查结果之间的可能关联。研究设计。研究了两个成年组：A组：接受透析的ESRD DM患者，B组：非ESRD DM患者（血清肌酐<2.0mg/dl）。记录已知的糖尿病病程时间、透析治疗类型和持续时间以及实验室结果。进行口腔检查，寻找体征、症状和与ESRD相关的OL。使用卡方检验、费舍尔精确检验以及95%置信区间的比值比（OR）分析关联。使用学生t检验比较年龄、透析时间和实验室结果。
共检查了229例个体，A组99例，B组130例。A组的体征和症状患病率更高：77.8%对57.6%，（P<0.001），其中尿毒症口臭（48.5%）、味觉异常（45.5%）和口干（44.4%）最为常见。OL在A组中也更普遍；65.6%对36.9%（P<0.001）。最常见的OL是唇干皲裂（28.3%）、舌苔厚腻（18.2%）和念珠菌病（17.2%）。两组之间念珠菌病患病率无差异。仅在A组中发现念珠菌病与口干（P<0.05）和平滑舌（P<0.05）相关。
与非ESRD DM患者相比，ESRD DM患者的体征、症状和OL患病率显著更高。A组中尿毒症口臭、口干、舌苔厚腻和念珠菌病的高患病率，可作为其他糖尿病患者未诊断出晚期肾病可能性的警示信号。
