Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan.
Gerodontology. 2021 Sep;38(3):300-307. doi: 10.1111/ger.12527. Epub 2020 Dec 27.
Despite the growing interest in oral health and chronic disease in geriatric medicine, the evidence of an association between the two variables is limited.
This study sought to examine the association between oral health status and chronic kidney disease (CKD) in this setting.
This retrospective study included consecutive post-acute patients in a rehabilitation hospital. Oral health status was evaluated using the Revised Oral Assessment Guide (ROAG). Renal function or CKD stage was assessed by measurement of the estimated glomerular filtration rate (eGFR). Multivariate logistic regression analysis was used to determine which subcategories of ROAG were independently associated with advanced CKD stages (vs. early CKD stages). Multiple linear regression analysis was used to clarify whether eGFR on admission was independently associated with ROAG score after adjusting for potential confounders.
A total of 1056 (mean age 70 years; 52% women) were included in the analysis. Slight and moderate-to-severe oral health problems were detected in 57.7% and 15.4% of patients, respectively. Patients with oral problems had a more severe stage of CKD (P = .036) and a lower eGFR (P = .028). Among subitems of ROAG, tongue (OR = 1.40, P = .041), saliva (OR = 1.72, P = .039) and oral cavity mucosa (OR = 1.37, P = .013) status was independently associated with the presence of CKD stages 3, 4 and 5. Furthermore, eGFR was independently associated with ROAG score (β = -0.180, P = .034) after adjusting for possible confounders.
Impaired oral health status is common and closely associated with CKD in post-acute inpatients.
尽管老年医学领域对口腔健康和慢性疾病的兴趣日益浓厚，但两者之间关联的证据有限。
本研究旨在探讨该环境下口腔健康状况与慢性肾脏病（CKD）之间的关系。
本回顾性研究纳入了康复医院连续收治的急性后期患者。使用修订后的口腔评估指南（ROAG）评估口腔健康状况。通过肾小球滤过率估计值（eGFR）测量评估肾功能或 CKD 分期。采用多变量逻辑回归分析确定 ROAG 的哪些亚类与晚期 CKD 分期（与早期 CKD 分期相比）独立相关。采用多元线性回归分析阐明在调整潜在混杂因素后，入院时的 eGFR 是否与 ROAG 评分独立相关。
共纳入 1056 例患者（平均年龄 70 岁，52%为女性）进行分析。分别有 57.7%和 15.4%的患者存在轻度和中重度口腔健康问题。有口腔问题的患者 CKD 分期更严重（P=0.036），eGFR 更低（P=0.028）。在 ROAG 的各个亚项中，舌（OR=1.40，P=0.041）、唾液（OR=1.72，P=0.039）和口腔黏膜（OR=1.37，P=0.013）状况与 CKD 3、4 和 5 期的存在独立相关。此外，在调整可能的混杂因素后，eGFR 与 ROAG 评分独立相关（β=-0.180，P=0.034）。
急性后期住院患者口腔健康状况受损较为常见，且与 CKD 密切相关。
