Dondjio Jemele Linda Jordane, Buzzi Marie, Petipa Nga Orly, Couchoud Cécile
Sorbonne Université, Paris, France.
Université de Lorraine, Inserm, INSPIIRE, 54000, Nancy, France.
J Nephrol. 2025 May 30. doi: 10.1007/s40620-025-02307-4.
Oral diseases have been shown to be risk factors of Chronic Kidney Disease (CKD) progression and may also be associated with poorer survival. The aim of this study was to describe oral care of dialysis patients in France and to assess its impact on their survival.
We conducted a retrospective cohort study including all patients on dialysis in France between 2015 and 2020. Data were collected from the French REIN registry and matched with the National Health Data System. Factors associated with the probability of receiving oral care treatments were explored using a logistic regression model. The survival of incident dialysis patients was modeled using a Cox model.
Among the 101,942 prevalent patients included in our sample, 32.5% received oral care treatment over the 6-year study period. Average annual adoption was 18.7% (versus 43% in the general French population) with regional variations. Male gender, overweight, dialysis treatment < 3 and > 6 years, and being on the transplant waiting list were associated with greater oral care treatment. Oral care treatment was associated with a lower risk of death (weighted hazard ratio (HR) 0.53 [0.51-0.55], adjusted HR 0.50 [0.48-0.52] 95% confidence interval (CI)).
Dialysis patients in France undergo a low level of oral care treatments. Patients' characteristics and regional practices appear to influence this. Oral care treatments seem to have a positive impact on survival.
口腔疾病已被证明是慢性肾脏病（CKD）进展的危险因素，也可能与较差的生存率相关。本研究的目的是描述法国透析患者的口腔护理情况，并评估其对患者生存率的影响。
我们进行了一项回顾性队列研究，纳入了2015年至2020年间法国所有接受透析的患者。数据从法国肾脏登记系统收集，并与国家卫生数据系统进行匹配。使用逻辑回归模型探索与接受口腔护理治疗可能性相关的因素。使用Cox模型对初治透析患者的生存率进行建模。
在我们样本中的101,942名现患患者中，32.5%在6年研究期间接受了口腔护理治疗。年平均接受率为18.7%（法国普通人群为43%），存在地区差异。男性、超重、透析治疗3年以下和6年以上以及在移植等待名单上与接受更多口腔护理治疗相关。口腔护理治疗与较低的死亡风险相关（加权风险比（HR）0.53 [0.51 - 0.55]，调整后HR 0.50 [0.48 - 0.52]，95%置信区间（CI））。
法国透析患者接受的口腔护理治疗水平较低。患者特征和地区做法似乎对此有影响。口腔护理治疗似乎对生存率有积极影响。
