Private Dental Clinic "Dr Mladenovic", Lasla Gala 30, 21000, Novi Sad, Serbia.
University of Novi Sad, Faculty of Medicine, Dental Clinic of Vojvodina, Oral Medicine Section, Hajduk Veljkova 12, 21000, Novi Sad, Serbia.
Arch Oral Biol. 2019 Jun;102:205-211. doi: 10.1016/j.archoralbio.2019.04.021. Epub 2019 May 1.
Chronic kidney disease (CKD) and dialysis treatment could affect oral mucosa and cause qualitative or quantitative changes of saliva.
The aim of the study was to investigate oral manifestations, unstimulated salivary flow rate (USFR), salivary pH value and biochemical composition of saliva in non-diabetic patients with CKD.
The study group (PD) consisted of 50 pre-dialysis patients diagnosed with CKD, positive control group (HD) of 25 haemodialysis patients and negative control (H) of 25 age and gender-matched healthy persons. Creatinine clearance rate (CrCl) was calculated from the blood creatinine using the Cockcroft-Gault formula. After a detailed intraoral examination, whole unstimulated saliva samples were collected to determine salivary pH value, and biochemical composition using a spectrophotometric method.
Statistical analysis revealed that PD subjects had more oral lesions (p < 0.05) and symptoms (p < 0.001) than controls. The mean CrCl was significantly lower (p < 0.05) in CKD subjects with pale mucosa, xerostomia, dysgeusia, and uremic odour, comparing to those without listed symptoms. PD subjects had significantly decreased USFR and increased pH, urea and creatinine than H controls (p < 0.05). A moderately strong positive correlation between serum and salivary creatinine in both PD (p < 0.05) and HD (p < 0.05) groups was found.
This study confirmed that xerostomia and dysgeusia are major symptoms among pre-dialysis patients. Their presence along with uremic odour and pale mucosa is directly related to decreased kidney function. On the diagnostic point, decreased USFR, especially hyposalivation and increased salivary creatinine, should be considered a significant indicator of CKD in stages before dialysis therapy.
慢性肾脏病（CKD）和透析治疗可影响口腔黏膜，导致唾液质量或数量发生变化。
本研究旨在探讨非糖尿病 CKD 患者的口腔表现、非刺激性唾液流率（USFR）、唾液 pH 值和唾液生化成分。
研究组（PD）由 50 名诊断为 CKD 的透析前患者组成，阳性对照组（HD）为 25 名血液透析患者，阴性对照组（H）为 25 名年龄和性别匹配的健康人。肌酐清除率（CrCl）采用 Cockcroft-Gault 公式从血液肌酐中计算得出。在详细的口腔检查后，收集全唾液样本以使用分光光度法测定唾液 pH 值和生化成分。
统计分析显示，PD 组患者的口腔病变（p<0.05）和症状（p<0.001）均多于对照组。黏膜苍白、口干、味觉障碍和尿毒症气味的 CKD 患者的平均 CrCl 明显降低（p<0.05），与无上述症状的患者相比。PD 组患者的 USFR 明显降低（p<0.05），pH 值、尿素和肌酐均高于 H 对照组（p<0.05）。PD 组和 HD 组患者的血清和唾液肌酐之间存在中度强正相关（p<0.05）。
本研究证实口干和味觉障碍是透析前患者的主要症状。这些症状与尿毒症气味和黏膜苍白并存，与肾功能下降直接相关。在诊断方面，USFR 降低，尤其是低流涎症和唾液肌酐增加，应被视为透析治疗前 CKD 的重要指标。
