Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil.
Division of Renal Transplant, Kidney and Hypertension Hospital, Federal University of São Paulo, São Paulo, Brazil.
Acta Odontol Scand. 2020 Apr;78(3):217-222. doi: 10.1080/00016357.2019.1685680. Epub 2019 Nov 13.
To identify the oral lesions of individuals with kidney disease immediately before and shortly after kidney transplantation, taking into account the immunosuppressive regimen, antiviral prophylaxis and type of transplantation. A prospective observational cohort study was carried from January 2017 to January 2018. Eighty individuals aged 18 years or older who were admitted for kidney transplantation were eligible to participate. Clinical data regarding medical history, immunosuppressive therapy, antiviral prophylaxis, laboratorial data and oral examination were performed by the same trained researcher, in three different moments: 24 hours before transplantation (1st time point), 15-20 days (2nd time point) and 45-60 days (3rd time point) after transplantation. In the first, second and third time points, it was found that 3.7% (3/80), 23.7% (18/76) and 25.7% (19/74) of the participants showed oral soft tissue lesions. Ulcers and candidiasis were the most frequent oral lesions, and they were associated with the use of everolimus ( = .005) and azathioprine ( = .034), respectively. Less patients reported xerostomia after transplantation than before ( < .001). Oral lesions are common in the short term after renal transplantation and are particularly related to both toxicities of immunosuppressive drugs and immunosuppression.
为了在接受肾移植前后立即识别出肾病患者的口腔病变，要考虑免疫抑制方案、抗病毒预防措施和移植类型。这是一项从 2017 年 1 月至 2018 年 1 月进行的前瞻性观察队列研究。符合条件的参与者为 80 名年龄在 18 岁或以上、因接受肾移植而入院的个体。由同一位经过培训的研究人员在三个不同时间点（移植前 24 小时[第 1 个时间点]、移植后 15-20 天[第 2 个时间点]和 45-60 天[第 3 个时间点]）采集有关病史、免疫抑制治疗、抗病毒预防、实验室数据和口腔检查的临床数据。在第 1、2 和第 3 个时间点，发现 3.7%（3/80）、23.7%（18/76）和 25.7%（19/74）的参与者出现口腔软组织病变。溃疡和念珠菌病是最常见的口腔病变，分别与依维莫司（ = .005）和硫唑嘌呤（ = .034）的使用有关。与移植前相比，移植后较少患者报告出现口干（ < .001）。肾移植后短期口腔病变很常见，与免疫抑制剂的毒性和免疫抑制均密切相关。
