Conclusion
The prevalence of oral lesions was higher in CKD subjects than in controls and the difference was statistically significant. Abnormal lip pigmentation, halitosis, periodontitis and candidiasis are some of the oral lesions seen. The presence of oral lesions was also associated with reduced GFR in both CKD and control subjects. The positive association between the presence of oral lesions and reduced GFR in healthy/control subjects is a pointer to the possible role(s) of oral lesions in the initiation and/or progression of renal disease.
In addition, this study showed the possibility of using presence of oral lesions to predict the severity of underlying renal problem as shown in Figure 1 where the relationship between the mean GFR and oral lesions were clearly shown. While the presence of oral candidiasis (seen in subjects very low GFR) may indicate a state of severe renal impairments, the presence of lesions like aphthous ulcer may reflect a just mild to moderate renal disease since they are usually seen at slightly below normal GFR.
(Enlarge Image)
Figure 1.
Mean GFR and oral lesions in CKD subjects.
Sequel to the impact of oral aspect of CKD in the quality of life of patients, it is therefore recommended that all patients with chronic kidney disease will benefit from dental care; therefore, they should be routinely evaluated for oral lesion(s) and treated accordingly. Likewise, dental evaluation and appropriate dental treatments should be given to all prospective kidney transplant patients before transplantation as well as regular review after the transplantation. More importantly, there is need for a closer relationship between nephrologists and dentists in the management of chronic renal patients so as to ensure optimal quality of life at all times.