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Prevalence and severity of oral disease in adults with chronic kidney disease: a systematic review of observational studies.
Nephrol Dial Transplant. 2014 Feb; 29(2):364-75.ND

Abstract

BACKGROUND

Oral disease may be increased in people with chronic kidney disease (CKD) and, due to associations with inflammation and malnutrition, represents a potential modifiable risk factor for cardiovascular disease and mortality. We summarized the prevalence of oral disease in adults with CKD and explored any association between oral disease and mortality.

METHODS

We used systematic review of observational studies evaluating oral health in adults with CKD identified in MEDLINE (through September 2012) without language restriction. We summarized prevalence and associations with all-cause and cardiovascular mortality using random-effects meta-analysis. We explored for sources of heterogeneity between studies using meta-regression.

RESULTS

Eighty-eight studies in 125 populations comprising 11 340 adults were eligible. Edentulism affected one in five adults with CKD Stage 5D (dialysis) {20.6% [95% confidence interval (CI), 16.4-25.6]}. Periodontitis was more common in CKD Stage 5D [56.8% (CI, 39.3-72.8)] than less severe CKD [31.6% (CI, 19.0-47.6)], although data linking periodontitis with premature death were scant. One-quarter of patients with CKD Stage 5D reported never brushing their teeth [25.6% (CI, 10.2-51.1)] and a minority used dental floss [11.4% (CI, 6.2-19.8)]; oral pain was reported by one-sixth [18.7% (CI, 8.8-35.4)], while half of patients experienced a dry mouth [48.4% (CI, 37.5-59.5)]. Data for kidney transplant recipients and CKD Stages 1-5 were limited.

CONCLUSIONS

Oral disease is common in adults with CKD, potentially reflects low use of preventative dental services, and may be an important determinant of health in this clinical setting.

Authors+Show Affiliations

Diaverum Medical Scientific Office, Bari, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

Language

eng

PubMed ID

24081863

Citation

Ruospo, Marinella, et al. "Prevalence and Severity of Oral Disease in Adults With Chronic Kidney Disease: a Systematic Review of Observational Studies." Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, vol. 29, no. 2, 2014, pp. 364-75.
Ruospo M, Palmer SC, Craig JC, et al. Prevalence and severity of oral disease in adults with chronic kidney disease: a systematic review of observational studies. Nephrol Dial Transplant. 2014;29(2):364-75.
Ruospo, M., Palmer, S. C., Craig, J. C., Gentile, G., Johnson, D. W., Ford, P. J., Tonelli, M., Petruzzi, M., De Benedittis, M., & Strippoli, G. F. (2014). Prevalence and severity of oral disease in adults with chronic kidney disease: a systematic review of observational studies. Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, 29(2), 364-75. https://doi.org/10.1093/ndt/gft401
Ruospo M, et al. Prevalence and Severity of Oral Disease in Adults With Chronic Kidney Disease: a Systematic Review of Observational Studies. Nephrol Dial Transplant. 2014;29(2):364-75. PubMed PMID: 24081863.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence and severity of oral disease in adults with chronic kidney disease: a systematic review of observational studies. AU - Ruospo,Marinella, AU - Palmer,Suetonia C, AU - Craig,Jonathan C, AU - Gentile,Giorgio, AU - Johnson,David W, AU - Ford,Pauline J, AU - Tonelli,Marcello, AU - Petruzzi,Massimo, AU - De Benedittis,Michele, AU - Strippoli,Giovanni F M, Y1 - 2013/09/29/ PY - 2013/10/2/entrez PY - 2013/10/2/pubmed PY - 2014/10/15/medline KW - chronic kidney disease KW - epidemiology KW - meta-analysis KW - oral health KW - periodontitis SP - 364 EP - 75 JF - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JO - Nephrol Dial Transplant VL - 29 IS - 2 N2 - BACKGROUND: Oral disease may be increased in people with chronic kidney disease (CKD) and, due to associations with inflammation and malnutrition, represents a potential modifiable risk factor for cardiovascular disease and mortality. We summarized the prevalence of oral disease in adults with CKD and explored any association between oral disease and mortality. METHODS: We used systematic review of observational studies evaluating oral health in adults with CKD identified in MEDLINE (through September 2012) without language restriction. We summarized prevalence and associations with all-cause and cardiovascular mortality using random-effects meta-analysis. We explored for sources of heterogeneity between studies using meta-regression. RESULTS: Eighty-eight studies in 125 populations comprising 11 340 adults were eligible. Edentulism affected one in five adults with CKD Stage 5D (dialysis) {20.6% [95% confidence interval (CI), 16.4-25.6]}. Periodontitis was more common in CKD Stage 5D [56.8% (CI, 39.3-72.8)] than less severe CKD [31.6% (CI, 19.0-47.6)], although data linking periodontitis with premature death were scant. One-quarter of patients with CKD Stage 5D reported never brushing their teeth [25.6% (CI, 10.2-51.1)] and a minority used dental floss [11.4% (CI, 6.2-19.8)]; oral pain was reported by one-sixth [18.7% (CI, 8.8-35.4)], while half of patients experienced a dry mouth [48.4% (CI, 37.5-59.5)]. Data for kidney transplant recipients and CKD Stages 1-5 were limited. CONCLUSIONS: Oral disease is common in adults with CKD, potentially reflects low use of preventative dental services, and may be an important determinant of health in this clinical setting. SN - 1460-2385 UR - https://www.unboundmedicine.com/medline/citation/24081863/Prevalence_and_severity_of_oral_disease_in_adults_with_chronic_kidney_disease:_a_systematic_review_of_observational_studies_ L2 - https://academic.oup.com/ndt/article-lookup/doi/10.1093/ndt/gft401 DB - PRIME DP - Unbound Medicine ER -