Oral Health Status in Diabetic and Non-Diabetic Patients on Maintenance Hemodialysis Treatment

Rambabova, Emilija and Gjorgjievska, Gordana and Krecova, Vasiliki and Pusevski, Vladimir and Sterjova Markovska, Zaklina and Biljali, Sefedin and Trajceska, Lada and Bushljetikj, Oliver and Trifunovski, Aleksandar and Carcev, Mile and Popovska, Mirjana (2022) Oral Health Status in Diabetic and Non-Diabetic Patients on Maintenance Hemodialysis Treatment. Bantao Journal (Journal of the Balkan Cities Association of Nephrology, Dialysis, Transplantation and Artificial Organs), 20 (2). pp. 39-44. ISSN 1312-2517

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Abstract

Introduction. Uremic toxins and inflammation influence
the oral health in patients on maintenance hemodialysis
treatment. The presence of diabetes additionally aggravates
the oral status. The aim of the study was to compare
the oral health status in diabetic and non-diabetic
patients on chronic hemodialysis program.
Methods. Observational, cross-section, monocentric
study was conducted in 72 hemodialysis (HD) patients
divided into two groups regarding the presence of
Diabetes mellitus (DM). Demographic characteristics
as patients age, dialysis vintage, laboratory inflammatory
markers as C-reactive protein (CRP), albumin and Interleukin
6 (IL-6) were measured at the start of the
study. Also, uremic small and middle molecules as blood
urea nitrogen (BUN), creatinine, β2-microglobilin (β2M),
myoglobin, albumin, free light chains kappa (FLC-k),
and free light chains lambda (FLC-λ) were analyzed.
Patients were examined by a dentist specialist scoring
the oral hygiene index (OHI) by Greene Vermillion as
good, fair and poor. Presence of hyperkeratosis, periodontal
disease, erosions, ulceration, erythema, pigmentations,
tongue coating and uremic fetor were notified.
Gingival hyperplasia (GH) was scored (1-3) with 3 for
the worst score. Data was presented as mean and
standard deviation for continuous and percentages for
nominal values. X squared Fisher exact and Mann-
Whitney test were used for statistical analysis. P<0.05
was considered as significant.
Results. The patients from group 1-with DM (N=26)
didn’t differ from the non-diabetic group (N=46) in
respect of gender, age but had significantly shorter
dialysis vintage (48.68±37.45 vs. 88.13±63.29, p=0.02,
respectively). From the inflammatory markers only Il-
6 was significantly higher in DM patients (p=0.03).
All the analyzed uremic toxins-small and middle molecules
also didn’t differ between the two groups.
Diabetic patients were at 3 fold risk for manifestation
of fissure, 4 fold risk for pigmentations and 7 fold risk
for erythema (OR 3.58; CI:1.017-12.380, p= 0.003; OR
4.12; CI:0.684-22.870; p=0.02, OR 4.84; CI:1.343-17.498,
p=0.000), (OR 7.25; CI:1.123-46.880, p=0.000), respectively.
GH was more likely to be present in diabetic patients
(35%, 54%, 11% vs 83%, 15, 0%, p=0.000, respectively).
The presence of hyperkeratosis, periodontal
disease, erosions, didn’t differ between the groups.
Patients with DM were found with higher percentage
of bad oral hygiene index (38% vs 20%), but the overall
comparison of OHI showed no significant difference.
Conclusion. Oral health is significantly deteriorated in
dialysis patients, especially in those with inflammation.
Diabetic patients are at higher risk of developing changes
in the oral health status.
Keywords: hemodialysis, oral health, diabetes

Item Type:	Article
Subjects:	Medical and Health Sciences > Basic medicine Medical and Health Sciences > Clinical medicine Medical and Health Sciences > Health sciences Medical and Health Sciences > Other medical sciences
Divisions:	Faculty of Medical Science
Depositing User:	Cena Dimova
Date Deposited:	12 Dec 2023 12:07
Last Modified:	12 Dec 2023 12:07
URI:	https://eprints.ugd.edu.mk/id/eprint/32844

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