Oral mucosa symptoms, signs and lesions, in end stage renal disease and non-end stage renal disease diabetic patients.

AIM: To assess oral signs, symptoms and oral lesions (OL) type and prevalence, in diabetic patients with end stage renal disease (ESRD DM), and compare them with analogous findings in a non-ESRD DM group; analyze the possible association between oral manifestations, as well as with relevant laboratory findings. Research design. Two adult groups were studied: Group A: ESRD DM on dialysis, and group B: non-ESRD DM (serum creatinine <2.0 mg/dl). Known DM evolution time, dialysis treatment type and duration, and laboratory results were recorded. An oral exam was performed, searching for signs, symptoms and ESRD-associated OL. Associations were analyzed using Chi square, Fisher s exact test, and odds ratios (OR) with 95% confidence intervals. Ages, time on dialysis, and laboratory results were compared with Student s t test. RESULTS: 229 individuals were examined, group A 99, and group B 130 pts. Signs and symptoms prevalence was higher in group A: 77.8% vs. 57.6%, (P<0.001), uremic breath (48.5%), unpleasant taste (45.5%) and xerostomia (44.4%) being the most frequent ones. OL were also more prevalent in group A; 65.6% vs. 36.9% (P<0.001). The most frequent OL were dry, fissured lips (28.3%), saburral tongue (18.2%) and candidiasis (17.2%). No difference was found in candidiasis prevalence between groups. Candidiasis was found associated to xerostomia (P<0.05) and smooth tongue (P<0.05) only in group A. CONCLUSIONS: ESRD DM patients had a significantly higher prevalence of signs, symptoms and OLs, as compared to non-ESRD DM pts. The high prevalence of uremic fetor, xerostomia, saburral tongue and candidiasis in group A, could be tried as warning signs on the possibility of non diagnosed advanced renal disease in other diabetic patients.

Oral mucosa symptoms, signs and lesions, in end stage renal disease and non-end stage renal disease diabetic patients

Objetivos. Conocer el tipo y frecuencia de signos, síntomas y lesiones bucales (LB) en pacientes diabéticos (DM) con insuficiencia renal crónica (IRCT), y compararlos con un grupo de DM sin IRCT. Investigar la posible asociación de las manifestaciones bucales entre sí, y con resultados de laboratorio relevantes. Diseño del estudio. Fueron dos grupos de adultos: grupo A: DM con IRCT y diálisis, y grupo B: DM sin IRCT (con creatinina sérica <2.0 mg/dl). Se registró tiempo de evolución conocida de la DM, tipo y duración del tratamiento dialíticoy resultados de laboratorio. Se realizó un examen bucal registrando signos, síntomas y LB asociadas a IRCT. Las asociaciones se investigaron con χ2, prueba exacta de Fisher y razón de momios (RM) con límites confianza de 95%. Las edades, el tiempo en diálisis y los resultados de laboratorio se compararon con prueba de T de Student.Resultados. Fueron 229 sujetos; grupo A 99 y grupo B 130. La frecuencia de signos, síntomas fue mayor en el grupo A: 77.8 % vs. 57.6%, (P <0.001); los más frecuentes fueron aliento urémico 48.5%, sabor desagradable 45.5% y xerostomía 44.4%. Las LB también fueron más frecuentes en el grupo A; 65.6% vs. 36.9%, (P<0.001). Las más frecuentes fueron labios secos y fisurados 28.3%, lengua saburral 18.2% y candidosis 17.2%. No se encontró diferencia en la prevalencia de candidosis entre los dos grupos. La candidosis se asoció con xerostomía (P<0.05) y con dorso de lengua liso (P<0.05) solo en el grupo A.Conclusiones. Los diabéticos con IRCT presentaron un número significativamente mayor de signos, síntomas y LB que los diabéticos sin IRCT. La elevada frecuencia de aliento urémico, xerostomía, lengua saburral y candidosis en el grupo A, podríanprobarse como señales de alerta sobre la posibilidad de enfermedad renal avanzada en otros pacientes diabéticos

Aim: To assess oral signs, symptoms and oral lesions (OL) type and prevalence, in diabetic patients with end stage renaldisease (ESRD DM), and compare them with analogous findings in a non-ESRD DM group; analyze the possible association between oral manifestations, as well as with relevant laboratory findings.Research design. Two adult groups were studied: Group A: ESRD DM on dialysis, and group B: non-ESRD DM (serum creatinine <2.0 mg/dl). Known DM evolution time, dialysis treatment type and duration, and laboratory results were recorded. An oral exam was performed, searching for signs, symptoms and ESRD-associated OL. Associations were analyzed using Chi square, Fisher’s exact test, and odds ratios (OR) with 95% confidence intervals. Ages, time on dialysis, and laboratory results were compared with Student’s t test.Results: 229 individuals were examined, group A 99, and group B 130 pts. Signs and symptoms prevalence was higher in group A: 77.8% vs. 57.6%, (P<0.001), uremic breath (48.5%), unpleasant taste (45.5%) and xerostomia (44.4%) being the most frequent ones. OL were also more prevalent in group A; 65.6% vs. 36.9% (P<0.001). The most frequent OL were dry, fissured lips (28.3%), saburral tongue (18.2%) and candidiasis (17.2%). No difference was found in candidiasis prevalence between groups. Candidiasis was found associated to xerostomia (P<0.05) and smooth tongue (P<0.05) only in group A.Conclusions. ESRD DM patients had a significantly higher prevalence of signs, symptoms and OLs, as compared to non-ESRD DM pts. The high prevalence of uremic fetor, xerostomia, saburral tongue and candidiasis in group A, could be tried as warning signs on the possibility of non diagnosed advanced renal disease in other diabetic patients

Lesiones bucales en un grupo de pacientes con trasplante renal / Oral lesions in a group of kidney transplant patients

Objetivo: Determinar la prevalencia de lesiones de la mucosabucal (LB) en un grupo de pacientes con trasplante renal (TR),y analizar las posibles asociaciones de las lesiones entre sí, con el uso de fármacos y con variables clínicas y de laboratorio relevantes. Metodología. Estudio transversal, en el que se examinó a pacientes consecutivos con TR de la consulta de nefrología de un hospital General de Zona del Instituto Mexicano del Seguro Social. Se determinó la frecuencia y el tipo de lesiones bucales. Se analizaron las posibles asociaciones de las LB entre sí y conla cuenta de leucocitos totales, la función renal, el índice de higiene oral simplificado (IHO-S), los niveles de ciclosporina A(CsA) en sangre y el uso de nifedipina. Se utilizó un modelo de regresión logística para analizar la asociación entre hiperplasia gingival (HG) y la dosis de CsA y de nifedipina. Resultados. Se examinaron 50 (55.6%) hombres y 40 (44.4%)mujeres. El 60% de los pacientes presentaron al menos una lesión bucal. Se presentó candidosis bucal (CB) en 18.7%, lesiones clínicamente compatibles con leucoplasia vellosa (CLV) en13%. Se identificó asociación entre la presencia de CB y CLV(P<0.05). Se encontró lengua saburral (LS) en 22% de los pacientes,e HG en 49%; Grado 1 en 11 (12.2%); Grado 2 en 26(28.9%) y Grado 3 en 7 (7.8%). Los resultados de la regresión logística demostraron asociación de HG con mala higiene bucal(P<0.001), pero no con la dosis o los niveles de CsA, ni con el uso de nifedipina (P=0.075). Conclusión. El 60% de los pacientes con TR presentó al menos una lesión en la mucosa bucal. La asociación entre HG y mala higiene bucal demuestra la necesidad de supervisar la higiene bucal en el paciente trasplantado

Aim: To assess the prevalence of oral mucosa lesions (OL) in a group of kidney transplant (KT) patients, and analyze possible OL associations with one another and with drugs use and relevant clinical and laboratory variables. Methodology. Transversal study, in which consecutive KT patients from the nephrology outpatient service at a General Zonal Hospital were examined. The prevalence of several types of OL was assessed, and their possible statistical associations with one another and total leukocyte count, renal function, the simplified oral hygiene index (S-OHI), cyclosporin-A (CsA) dose and blood levels, and nifedipine use was analyzed. A logistic regression model was used to analyze the association between gingival hyperplasia (GH) and CsA dose and nifedipine use. Results. Fifty (55.6%) men and forty (44.4%) women were studied. Sixty percent of the patients had at least one OL. Oral candidiasis (OC) was found in 18.7%; 13% had lesions clinically compatible with hairy leukoplakia (CHL). An association was found between OC and CHL (P<0.05). Saburral tongue(ST) was found in 22% of the patients and gingival hyperplasia (GH) in 49%, which was distributed as follows: Grade 1 in11 (12.2%); Grade 2 in 26 (28.9%), and Grade 3 in 7 (7.8%).Logistic regression results showed an association between GH and poor oral hygiene (P<0.001), but not to either CsA dose or blood levels, or nifedipine use (P=0.075). Conclusion. Sixty percent of the KT patients had at least one OL. The association between GH and poor oral hygiene corroborate the need for oral hygiene practices supervision in the transplant patient

Oral lesions in a group of kidney transplant patients.

AIM: To assess the prevalence of oral mucosa lesions (OL) in a group of kidney transplant (KT) patients, and analyze possible OL associations with one another and with drugs use and relevant clinical and laboratory variables. METHODOLOGY: Transversal study, in which consecutive KT patients from the nephrology outpatient service at a General Zonal Hospital were examined. The prevalence of several types of OL was assessed, and their possible statistical associations with one another and total leukocyte count, renal function, the simplified oral hygiene index (S-OHI), cyclosporin-A (CsA) dose and blood levels, and nifedipine use was analyzed. A logistic regression model was used to analyze the association between gingival hyperplasia (GH) and CsA dose and nifedipine use. RESULTS: Fifty (55.6%) men and forty (44.4%) women were studied. Sixty percent of the patients had at least one OL. Oral candidiasis (OC) was found in 18.7%; 13% had lesions clinically compatible with hairy leukoplakia (CHL). An association was found between OC and CHL (P<0.05). Saburral tongue (ST) was found in 22% of the patients and gingival hyperplasia (GH) in 49%, which was distributed as follows: Grade 1 in 11 (12.2%); Grade 2 in 26 (28.9%), and Grade 3 in 7 (7.8%). Logistic regression results showed an association between GH and poor oral hygiene (P< 0.001), but not to either CsA dose or blood levels, or nifedipine use (P=0.075). CONCLUSION: Sixty percent of the KT patients had at least one OL. The association between GH and poor oral hygiene corroborate the need for oral hygiene practices supervision in the transplant patient.