García-Rios Paula, Rodríguez-Lozano Francisco Javier, Pérez-Guzmán Nuria
Gerodontologý an Special Care Dentistry Unit, Morales Meseguer Hospital, Faculty of Medicine, IMIB-Arrixaca, University of Murcia, 30008 Murcia, Spain.
J Clin Med. 2025 Jun 19;14(12):4380. doi: 10.3390/jcm14124380.
Chronic kidney disease (CKD) is defined as a clinical syndrome secondary to a permanent change in kidney function or structure, making it irreversible. Most patients at the onset of the disease are asymptomatic or present nonspecific symptoms, including signs and symptoms at the oral level. These manifestations, such as hyposalivation, increased calculus index, enamel defects, or changes in saliva composition, contribute to the diagnosis of this pathology and can also significantly affect the patient's quality of life. The aim is to systematically assess the presence and relevance of oral manifestations in patients with CKD, and to identify correlations between these symptoms and clinical parameters such as glomerular filtration rate or concomitant conditions of the patient. A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search was carried out in the PubMed, Scopus, Scielo, and The Cochrane Library databases on 7 April 2025, using terms related to "chronic kidney disease" and "oral manifestations". Inclusion criteria referred to observational studies published in the last ten years that reported oral symptoms in patients with CKD. The quality of cohort and case-control studies was assessed using the Newcastle-Ottawa Scale (NOS), while for cross-sectional studies, the Joanna Briggs Institute (JBI) critical appraisal checklist was used. A total of 27 studies met the inclusion criteria, primarily cross-sectional in design. The most frequently reported oral manifestations included hyposalivation, increased calculus and plaque indices, enamel defects, periodontal disease, and oral candidiasis. Significant associations were identified between the duration of dialysis and severity of periodontal disease, as well as between CKD stage and taste dysfunction. Findings varied by age group and CKD stage, with children showing distinct salivary profiles and adults presenting more pronounced periodontal and mucosal conditions. This review highlights a clear relationship between CKD and various oral health disturbances, although more studies are needed to better understand oral-systemic interactions in CKD. What is necessary is the establishment of multidisciplinary care approaches.
慢性肾脏病（CKD）被定义为一种继发于肾功能或结构永久性改变的临床综合征，具有不可逆性。大多数患者在疾病初发时无症状或表现为非特异性症状，包括口腔层面的体征和症状。这些表现，如唾液分泌减少、结石指数增加、牙釉质缺陷或唾液成分变化，有助于该疾病的诊断，也会显著影响患者的生活质量。目的是系统评估CKD患者口腔表现的存在情况及相关性，并确定这些症状与临床参数（如肾小球滤过率）或患者伴随疾病之间的关联。按照系统评价和Meta分析的首选报告项目（PRISMA）指南进行了一项系统评价。于2025年4月7日在PubMed、Scopus、Scielo和考克兰图书馆数据库中进行检索，使用与“慢性肾脏病”和“口腔表现”相关的术语。纳入标准涉及过去十年发表的报告CKD患者口腔症状的观察性研究。队列研究和病例对照研究的质量使用纽卡斯尔-渥太华量表（NOS）进行评估，而横断面研究则使用乔安娜·布里格斯研究所（JBI）的批判性评价清单。共有27项研究符合纳入标准，主要为横断面设计。最常报告的口腔表现包括唾液分泌减少增加、结石和菌斑指数增加、牙釉质缺陷、牙周病和口腔念珠菌病。在透析时间与牙周病严重程度之间以及CKD分期与味觉功能障碍之间发现了显著关联。研究结果因年龄组和CKD分期而异，儿童表现出独特的唾液特征，而成人则表现出更明显的牙周和黏膜状况。本综述强调了CKD与各种口腔健康问题之间的明确关系，尽管需要更多研究来更好地理解CKD中的口腔-全身相互作用。有必要建立多学科护理方法。
