Oral manifestations and salivary alterations in patients with End-Stage Renal Disease

Background: Salivary alterations in patients with End-stage Renal Disease(ESRD) may result in dental and oral problems. Objective: To determine oral manifestations and salivary alterations in patients with ESR D. Methods: This case-control study was performed on 20 ESRD patients undergoing hemodialysis and 20 control subjects. Salivary concentrations of urea and calcium and pH level were measured for all subjects. Moreover, paleness of the skin and oral mucosal, symptoms of xerostomia, halitosis, uremic stomatitis, taste sensitivity and radiographic changes were studied. Findings: There was a significant difference (p<0.05) in the average value of salivary urea concentration between two groups (48.7 mg/dl in patients group and 14.85mg/dl in control group). Also a meaningful statistical difference (p<0.05) was noted while comparing the level of salivary pH between two groups (7.905 in patient group and 6.64 in control group. Statistically, no significant difference for calcium concentration between two groups was found. The majority of patients (95%) had signs of skin and mucosal paleness and 80% complained of xerostomia while there was no sign of such symptoms in control group. There were also meaningful differences in intensity of halitosis and urmic stomatitis between the two groups (p<0.05). Conclusion: ESRD can lead to an increase in the level of salivary urea, pH, xerostomia, skin and mucosal paleness, and also results in halitosis and uremic stomatitis.