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Dembowska E, Jaroń A, Gabrysz-Trybek E, Bladowska J, Gacek S, Trybek G. Quality of Life in Patients with End-Stage Renal Disease Undergoing Hemodialysis. J Clin Med 2022; 11:jcm11061584. [PMID: 35329910 PMCID: PMC8949549 DOI: 10.3390/jcm11061584] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/04/2022] [Accepted: 03/11/2022] [Indexed: 02/05/2023] Open
Abstract
End-stage renal disease and hemodialysis therapy cause a number of changes, not only somatic but also psychosocial, including the patient’s perception and assessment of their quality of life. The literature describes predispositions to pathologies in the oral mucosa, craniofacial bones, teeth, and surrounding tissues in hemodialysis patients. This study aimed to determine the quality of life of hemodialysis patients in comparison with healthy subjects. The study group consisted of 200 subjects: the HD group (hemodialysis patients, n = 100) and the K group (control group, n = 100). General health and oral status were assessed using the following indices: plaque index, gingival index, probing depth, and clinical adhesion level. The WHOQOL-BREF survey was performed to determine both groups’ overall quality of life. The results showed lower values of assessed quality-of-life parameters in hemodialysis patients compared to the control group, especially in the somatic sphere. General diseases such as oral mycosis, osteoporosis, rheumatoid arthritis, and coronary-artery disease negatively impact the perceived quality of life. There are numerous indications for comprehensive psychological care of hemodialysis patients due to their poor psychosocial status.
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Affiliation(s)
- Elżbieta Dembowska
- Department of Periodontology, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland; (E.D.); (S.G.)
| | - Aleksandra Jaroń
- Department of Oral Surgery, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland;
| | - Ewa Gabrysz-Trybek
- Department of Diagnostic Imaging and Interventional Radiology, Pomeranian Medical University, Unii Lubelskiej 1, 71-242 Szczecin, Poland;
| | - Joanna Bladowska
- Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, M. Curie-Skłodowskiej 68, 50-369 Wrocław, Poland;
| | - Szymon Gacek
- Department of Periodontology, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland; (E.D.); (S.G.)
| | - Grzegorz Trybek
- Department of Oral Surgery, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland;
- Correspondence:
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Abou-Bakr A, Hussein RR, Khalil E, Ahmed E. The frequency of periodontitis in end-stage renal disease on hemodialysis in a sample of Egyptian population: multi-center clinical cross-sectional study. BMC Oral Health 2022; 22:1. [PMID: 34980089 PMCID: PMC8725326 DOI: 10.1186/s12903-021-02032-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 12/22/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND There is a general assumption that periodontal disease is highly prevalent among patients with chronic renal failure undergoing hemodialysis. The aim of the study to estimate the frequency of periodontitis in patients on hemodialysis among a sample of the Egyptian population, as well as the correlation between different clinical parameters of periodontal status with serum creatinine and blood urea. This may rule out the bidirectional relationship between periodontitis and renal failure in patients on hemodialysis. METHODS The study was conducted on 263 hemodialysis patients (165 males and 98 females) at three dialysis centers in Benha Governorate, Egypt (Benha Hospital, Tukh hospital, Qalyub hospital). Periodontal parameters including plaque index (PI), gingival index (GI), clinical attachment level (CAL), and probing pocket depth (PPD) had been recorded in these patients. Serum urea and creatinine levels had been measured, the data had been collected and undergone statistical analysis. RESULTS Frequency of periodontitis was 85.6% with stage III is the most prevalent stage. There was a significant positive strong correlation between age and periodontitis stage (rs = 0.707, p < 0.001). There was a positive correlation between clinical parameters and serum creatinine level. CONCLUSION In the present study, a high frequency of periodontitis had been found among ESRD patients on hemodialysis in the severe form (stage III) periodontitis. There was a significant direct correlation between the severity of periodontitis and CAL with a duration of hemodialysis. There was a weak insignificant association between periodontal indices (PD, BOP, and plaque score) and duration of hemodialysis.
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Affiliation(s)
- Asmaa Abou-Bakr
- Oral Medicine and Periodontology, Faculty of Dentistry, The British University in Egypt, El Sherouk City, Egypt
| | - Radwa R. Hussein
- Oral Medicine and Periodontology, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Eman Khalil
- Oral Medicine and Periodontology, Faculty of Dentistry, The British University in Egypt, El Sherouk City, Egypt
| | - Enji Ahmed
- Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, Giza, Egypt
- Oral Medicine and Periodontology, Faculty of Dentistry, The British University in Egypt, El Sherouk City, Egypt
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France K, AlMuzaini AAAY, Mupparapu M. Radiographic Interpretation in Oral Medicine and Hospital Dental Practice. Dent Clin North Am 2021; 65:509-528. [PMID: 34051928 DOI: 10.1016/j.cden.2021.02.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Oral medicine practice includes the diagnosis and nonsurgical treatment of oral and orofacial diseases and oral manifestations of systemic conditions. Oral medicine specialists in medical and dental settings often require imaging in assessment and treatment of these conditions. This article reviews imaging that may be used in practice, particularly as relevant for facial pain, bone conditions, and salivary gland disease. It reviews imaging that may be considered in a hospital setting for assessment of admitted patients, patient evaluation before surgical procedures, and provision of dentistry in a hospital setting for patients who cannot submit to treatment in an outpatient setting.
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Affiliation(s)
- Katherine France
- University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104, USA.
| | | | - Mel Mupparapu
- University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104, USA
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Rajendran M, Looney S, Singh N, Elashiry M, Meghil MM, El-Awady AR, Tawfik O, Susin C, Arce RM, Cutler CW. Systemic Antibiotic Therapy Reduces Circulating Inflammatory Dendritic Cells and Treg-Th17 Plasticity in Periodontitis. THE JOURNAL OF IMMUNOLOGY 2019; 202:2690-2699. [PMID: 30944162 DOI: 10.4049/jimmunol.1900046] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 03/05/2019] [Indexed: 01/08/2023]
Abstract
Periodontitis (PD) is a common dysbiotic inflammatory disease that leads to local bone deterioration and tooth loss. PD patients experience low-grade bacteremias with oral microbes implicated in the risk of heart disease, cancer, and kidney failure. Although Th17 effectors are vital to fighting infection, functional imbalance of Th17 effectors and regulatory T cells (Tregs) promote inflammatory diseases. In this study, we investigated, in a small pilot randomized clinical trial, whether expansion of inflammatory blood myeloid dendritic cells (DCs) and conversion of Tregs to Th17 cells could be modulated with antibiotics (AB) as part of initial therapy in PD patients. PD patients were randomly assigned to either 7 d of peroral metronidazole/amoxicillin AB treatment or no AB, along with standard care debridement and chlorhexidine mouthwash. 16s ribosomal RNA analysis of keystone pathogen Porphyromonas gingivalis and its consortium members Fusobacterium nucleatum and Streptococcus gordonii confirmed the presence of all three species in the reservoirs (subgingival pockets and blood DCs) of PD patients before treatment. Of the three species, P. gingivalis was reduced in both reservoirs 4-6 wk after therapy. Further, the frequency of CD1C+CCR6+ myeloid DCs and IL-1R1 expression on IL-17A+FOXP3+CD4+ T cells in PD patients were reduced to healthy control levels. The latter led to decreased IL-1β-stimulated Treg plasticity in PD patients and improvement in clinical measures of PD. Overall, we identified an important, albeit short-term, beneficial role of AB therapy in reducing inflammatory DCs and Treg-Th17 plasticity in humans with PD.
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Affiliation(s)
- Mythilypriya Rajendran
- Department of Periodontics, Dental College of Georgia at Augusta University, Augusta, GA 30912
| | - Stephen Looney
- Department of Biostatistics and Epidemiology, Medical College of Georgia, Augusta University, Augusta, GA 30912
| | - Nagendra Singh
- Department of Biochemistry and Molecular Biology, Augusta University, Augusta, GA 30912.,Cancer Research Center, Augusta University, Augusta, GA 30912
| | - Mahmoud Elashiry
- Department of Periodontics, Dental College of Georgia at Augusta University, Augusta, GA 30912
| | - Mohamed M Meghil
- Department of Periodontics, Dental College of Georgia at Augusta University, Augusta, GA 30912
| | - Ahmed R El-Awady
- Department of Research, Immunology Program, Children's Cancer Hospital, Cairo 57357, Egypt
| | - Omnia Tawfik
- Department of Oral Medicine and Periodontology, Cairo University, Cairo 12613, Egypt; and
| | - Cristiano Susin
- Department of Periodontology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599
| | - Roger M Arce
- Department of Periodontics, Dental College of Georgia at Augusta University, Augusta, GA 30912
| | - Christopher W Cutler
- Department of Periodontics, Dental College of Georgia at Augusta University, Augusta, GA 30912;
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Dental Care for Patients with End-Stage Renal Disease and Undergoing Hemodialysis. Int J Dent 2018; 2018:9610892. [PMID: 30538746 PMCID: PMC6258100 DOI: 10.1155/2018/9610892] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 09/11/2018] [Accepted: 10/02/2018] [Indexed: 12/15/2022] Open
Abstract
Chronic renal failure is a progressive disease characterized by a gradual destruction of nephrons and a consequent reduction of kidney function. End-stage renal disease (ESRD) necessitates renal replacement therapy as peritoneal dialysis, hemodialysis, or transplantation. Patients affected by ESRD or in hemodialysis are at risk for developing a number of comorbidities including hypertension, anemia, risk of bleeding, susceptibility to infection, medication side effects, and oral manifestations associated with the disease itself and with hemodialysis treatment. In this context, oral diseases represent a potential and preventable cause of poor health outcomes in people with ESRD due to their relation to infection, inflammation, and malnutrition. The aim of this article was to review ESRD and hemodialysis-associated manifestations and to describe the dental operative protocols for patients awaiting kidney transplantation in light of the most recent literature.
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Characteristics of bisphosphonate-related osteonecrosis of the jaw after kidney transplantation. J Craniofac Surg 2013; 23:e510-4. [PMID: 22976726 DOI: 10.1097/scs.0b013e31825b33f6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Renal transplantation is the definitive treatment of chronic renal failure, and osteoporosis in patients after renal transplantation is caused by the use of high-dose corticosteroids, reduced renal function, and the use of immunosuppressant. While bisphosphonates inhibit osteoclastic activities, they are the drug of choice for the treatment and prevention of osteoporosis. Bisphosphonate-related osteonecrosis of the jaw (BRONJ) becomes a problematic issue. There are few reports on BRONJ in patients after renal transplantation, so many oral bisphosphonates commonly prescribed in patients after renal transplantation to prevent osteoporosis have no warning of BRONJ. We analyzed the records of patients with BRONJ from January 2009 to December 2010. Among the patients with BRONJ, we selected patients who underwent transplantation of the kidney. Demographic data, drug-related factors, and clinical characteristics were evaluated using chart review. A total of 128 patients were categorized as having BRONJ, and there were 3 patients with a history of kidney transplantation. The average age was 54.6 years, and 2 victims were men. All patients received oral bisphosphonates for more than 2 years (range, 2-7 y; average, 58.6 mo). All patients had hypertension, diabetes mellitus, history of high-dose corticosteroids, and taking immunosuppressant drugs. Bisphosphonate-related osteonecrosis of the jaw occurred in the maxilla in all patients, which is classified as stage 3 because of the involved sinus. Extraction was the main provoking factor in all patients. In conclusion, even at a relatively young age, BRONJ in the maxilla can be developed by intake of oral bisphosphonate after kidney transplantation. Dental care for patients before and after undergoing renal transplantation should be emphasized to reduce the risk of BRONJ.
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Ziebolz D, Hraský V, Goralczyk A, Hornecker E, Obed A, Mausberg RF. Dental care and oral health in solid organ transplant recipients: a single center cross-sectional study and survey of German transplant centers. Transpl Int 2011; 24:1179-88. [DOI: 10.1111/j.1432-2277.2011.01325.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lee MM, Chu EY, El-Abbadi MM, Foster BL, Tompkins KA, Giachelli CM, Somerman MJ. Characterization of mandibular bone in a mouse model of chronic kidney disease. J Periodontol 2010; 81:300-9. [PMID: 20151810 PMCID: PMC2862731 DOI: 10.1902/jop.2009.090379] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Chronic kidney disease (CKD) is a worldwide health problem with increasing prevalence and poor outcomes, including severe cardiovascular disease and renal osteodystrophy. With advances in medical treatment, patients with CKD are living longer and require oral care. The aim of this study is to determine the effects of CKD and dietary phosphate on mandibular bone structure using a uremic mouse model. METHODS Uremia (U) was induced in female dilute brown agouti/2 mice by partial renal ablation. Uremic mice received a normal-phosphate (NP) or a high-phosphate (HP) diet. sham surgeries were performed in a control group of mice; half received an NP diet, and the other half was fed an HP diet. At termination, animals were sacrificed, and mandibles were collected for microcomputed tomography (micro-CT) and histologic analysis. RESULTS Sera levels of blood urea nitrogen, parathyroid hormone, and alkaline phosphatase were significantly increased in U/NP and U/HP mice versus sham controls, whereas serum calcium was increased in the U/HP group, and no differences were noted in serum phosphate levels among groups. Micro-CT analyses revealed a significant reduction in cortical bone thickness and an increase in trabecular thickness and trabecular bone volume/tissue volume in U/NP and U/HP groups compared to the sham/NP group. A significant reduction in cortical bone thickness was also found in the sham/HP group versus the sham/NP group. Histologic evaluation confirmed increased trabeculation in the U groups. CONCLUSION CKD in mice, especially under conditions of HP feeding, results in marked effects on alveolar bone homeostasis.
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Affiliation(s)
- Melissa M Lee
- Department of Periodontics, University of Washington School of Dentistry, Seattle, WA 98195-6365, USA
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