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透析时间和病因性肾病对肾移植前患者行牙牙槽外科手术或保守治疗的必要性的影响。

Frequency of the necessity of dentoalveolar surgery or conservative treatment in patients before kidney transplantation depending on the duration of dialysis and causative nephrological disease.

机构信息

Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Glueckstraße 11, 91054, Erlangen, Germany.

Department of Nephrology and Hypertension, University Hospital Erlangen, Erlangen, Germany.

出版信息

Clin Oral Investig. 2022 Mar;26(3):2383-2390. doi: 10.1007/s00784-021-04202-1. Epub 2021 Oct 8.

DOI:10.1007/s00784-021-04202-1
PMID:34623508
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8898213/
Abstract

OBJECTIVES

This retrospective study evaluates intraoral surgical and conservative treatment need in patients with a chronic kidney end-stage disease, depending on the duration of dialysis treatment and the causative nephrological disease.

MATERIAL AND METHODS

This study is based on data of patients referred to the Department of Oral and Maxillofacial Surgery of the University Hospital Erlangen, Germany, prior to kidney transplantation between January 2015 and March 2020. The necessity for oral surgical or dental therapy was determined by clinical and radiological examinations. Data on renal replacement therapy, cause of underlying renal disease, lifestyle, and general health were collected.

RESULTS

Data of N = 89 patients demonstrated that surgical treatment need depends on dialysis duration (p = 0.042). Patients, who had been dialyzing for 2 to 3 years showed the highest need for surgical intervention (80.0%; p = 0.024), followed by dialysis patients with a dialysis time of more than 3 years (48.1%). Similarly, dialysis patients in the second or third year of dialysis had the highest need for conservative treatment (73.3%; p > 0.05), followed by 55.6% of dialysis patients in the third year of dialysis.

CONCLUSIONS

Operative and conservative treatment is essential to optimize subsequent kidney transplantation. The greatest necessity could be detected for patients in the second and third years of dialysis.

CLINICAL RELEVANCE

Oral health addressing surgical and conservative treatment need depends on the duration of dialysis in patients with a chronic kidney end-stage disease.

摘要

目的

本回顾性研究根据透析治疗持续时间和病因性肾病,评估慢性肾脏病终末期患者的口腔内手术和保守治疗需求。

材料与方法

本研究基于 2015 年 1 月至 2020 年 3 月期间,德国埃尔兰根大学医院口腔颌面外科转诊的患者数据。通过临床和影像学检查确定口腔手术或牙科治疗的必要性。收集关于肾脏替代治疗、潜在肾脏疾病的病因、生活方式和一般健康的数据。

结果

N=89 例患者的数据表明,手术治疗需求取决于透析持续时间(p=0.042)。透析 2-3 年的患者手术干预需求最高(80.0%;p=0.024),其次是透析时间超过 3 年的透析患者(48.1%)。同样,透析第二年和第三年的透析患者对保守治疗的需求最高(73.3%;p>0.05),其次是透析第三年的透析患者(55.6%)。

结论

手术和保守治疗对于优化后续的肾脏移植至关重要。透析第 2 年和第 3 年的患者需求最大。

临床意义

对于慢性肾脏病终末期患者,口腔健康需要关注手术和保守治疗需求,取决于透析的持续时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f2e/8898213/725bab7fb863/784_2021_4202_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f2e/8898213/70fca6df9d8e/784_2021_4202_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f2e/8898213/1c0a1ca3e228/784_2021_4202_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f2e/8898213/d3baa4862b17/784_2021_4202_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f2e/8898213/725bab7fb863/784_2021_4202_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f2e/8898213/70fca6df9d8e/784_2021_4202_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f2e/8898213/1c0a1ca3e228/784_2021_4202_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f2e/8898213/d3baa4862b17/784_2021_4202_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f2e/8898213/725bab7fb863/784_2021_4202_Fig4_HTML.jpg

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本文引用的文献

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[Oral health status of patients undergoing hemodialysis: a Meta-analysis].[接受血液透析患者的口腔健康状况:一项Meta分析]
Hua Xi Kou Qiang Yi Xue Za Zhi. 2017 Apr 1;35(2):155-161. doi: 10.7518/hxkq.2017.02.009.
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Oral health in predialysis patients with emphasis on periodontal disease.以牙周病为重点的透析前患者的口腔健康
Quintessence Int. 2015 Nov-Dec;46(10):899-907. doi: 10.3290/j.qi.a34698.
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Oral health of hemodialysis patients: a cross-sectional study at two German dialysis centers.血液透析患者的口腔健康:德国两个透析中心的横断面研究
Hemodial Int. 2012 Jan;16(1):69-75. doi: 10.1111/j.1542-4758.2011.00606.x.