Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Preventive and Community Dentistry, Uberlândia, MG, Brazil.
Universidade Estadual de Campinas - Unicamp, School of Dentistry of Piracicaba, Department of Restorative Dentistry, Endodontics Division, Piracicaba, SP, Brazil.
Braz Oral Res. 2020 Dec 18;35:e016. doi: 10.1590/1807-3107bor-2021.vol35.0016. eCollection 2020.
This study aimed to assess whether the reductions in serum urea and creatinine levels are different from the reductions in salivary urea and creatinine levels that occur after hemodialysis in chronic renal patients. The systematic review protocol was registered in the PROSPERO database. Eight databases were searched to identify pretest-posttest studies of chronic kidney disease patients undergoing hemodialysis, with no language or year restrictions. The JBI Critical Appraisal Tool was used to assess the risk of bias. Meta-analyses using random-effect models were conducted to compare salivary and serum correlations and to pooled mean and proportion differences from pre- to posthemodialysis urea and creatinine levels by subgroup analysis. The I2 test was used to assess heterogeneity, and a meta-regression was performed to statistically assess correlations and differences in the pooled effects pre- and postdialysis. The Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) was used to assess the certainty of evidence. The search resulted in 1404 records, and only six studies (n = 252 participants) fulfilled the eligibility criteria and were included. The studies were published between 2013 and 2018. All studies showed a significant reduction in both salivary and serum urea/creatinine levels. All eligible studies presented a low risk of bias. The meta-analysis shows a moderate to high correlation between salivary and blood levels of urea (r: 0.79; 95% CI: 0.56-1.00) and creatinine (r: 0.64; 95%CI: 0.16-1.00), with a very low level of certainty. The reductions in salivary urea and creatinine levels are similar to and correlated with the reductions in blood urea and creatine levels after hemodialysis among chronic kidney disease patients.
本研究旨在评估慢性肾病患者血液透析后血清尿素和肌酐水平降低与唾液尿素和肌酐水平降低是否存在差异。系统评价方案已在 PROSPERO 数据库中注册。共检索了 8 个数据库，以确定接受血液透析的慢性肾脏病患者的测试前-测试后研究，无语言和年份限制。使用 JBI 批判性评估工具评估偏倚风险。使用随机效应模型进行荟萃分析，以比较唾液和血清相关性，并通过亚组分析比较血液透析前后尿素和肌酐水平的 pooled mean 和比例差异。使用 I2 检验评估异质性，并进行荟萃回归分析，以统计学评估透析前后 pooled 效应的相关性和差异。使用推荐、评估、开发和评估分级（GRADE）评估证据确定性。检索结果产生了 1404 条记录，只有 6 项研究（n = 252 名参与者）符合纳入标准并被纳入。研究发表于 2013 年至 2018 年。所有研究均显示唾液和血清尿素/肌酐水平均显著降低。所有符合条件的研究均显示出低偏倚风险。荟萃分析显示唾液和血液中尿素（r：0.79；95%置信区间：0.56-1.00）和肌酐（r：0.64；95%置信区间：0.16-1.00）之间存在中度至高度相关性，确定性水平非常低。慢性肾脏病患者血液透析后，唾液尿素和肌酐水平的降低与血液尿素和肌酐水平的降低相似且相关。
