Oral Health Status in Chronic Kidney Disease Patients With/Without Hemodialysis

Objectives: Circa 70,000 patients with end-stage renal disease are treated in Germany with hemodialysis or peritoneal dialysis at present. The objective of this study is to identify differences in the oral health status in patients with chronic kidney disease with/without hemodialysis.
Methods: 100 CKD outpatients with or without hemodialysis at the University Medical Center of the Johannes Gutenberg University Mainz (Germany) are to be enrolled in the study. Oral health was assessed using as variables the community periodontal index (CPI), microbiological analysis (Pado Test 4.5, IAI AG, Zuchwil, Switzerland), DMFT- index and prosthetic status. Chronic kidney disease was defined following the KDIGO guidelines and various blood tests were performed. Furthermore, patients had to fill in a questionnaire concerning socio-economical status, oral health habits, comorbidities and pruritus. Statistical analyses of the preliminary results were strictly descriptive, to be followed by multiple regression analyses for definitive results.
Results: Interim results of the study are presented. A total of 58 patients aged 21-84 years, 40 (69%) males and 18 (31%) females, were included in the study. Preliminary evaluations show for the hemodialysis patient group a trend towards higher CPI scores than the group without hemodialysis: 32% of patients in the hemodialysis group had a maximum CPI score 4, and 42% a maximum CPI score 3. In the non-hemodialysis group 44% patients had a maximum CPI score 3 and 50% a maximum CPI score 2 (Fig.1). Also, the values for crevicular total bacterial load were higher in the hemodialysis group (Fig.2).
Conclusions: The trend of oral health parameters being worse in hemodialysis patients could be indication for a possible relationship between periodontal diseases and requirement for hemodialysis in CKD patients. Definitive results and analyses, especially of biochemical markers (e.g. serum calcium, serum phosphorus), will be presented after completion of the study.