ORAL IMPLICATIONS OF CHRONIC KINDEY DISEASE: A CASE SERIES

Abstract

Background: Chronic Kidney Disease (CKD) is a progressive systemic disorder characterized by a gradual loss of kidney function over time. This decline often results in various complications, including significant oral health issues. These oral manifestations may arise directly from systemic effects of CKD or indirectly due to medications used for its treatment. Common oral complications include candidiasis, de-papillated tongue, and acute necrotizing ulcerative gingivitis (ANUG), each posing distinct diagnostic and management challenges.

Objective: To present and analyze three clinical cases of oral manifestations in patients with different stages of CKD, highlighting the importance of a multidisciplinary approach to oral care in these individuals.

Methods: This case series evaluated three patients diagnosed with CKD who presented with distinct oral health issues. Comprehensive oral examinations were conducted using the Community Periodontal Index for Treatment Needs (CPITN) and the Decayed, Missing, and Filled Teeth (DMFT) index. Clinical findings were confirmed with histopathological evaluations when necessary. Each case was managed using condition-specific treatments, including topical and systemic antifungals, oral hygiene therapy, and supportive care such as hydration and nutritional counseling.

Results:

• Case 1: A 35-year-old male with end-stage renal disease (serum creatinine: 10 mg/dL) undergoing dialysis presented with candidiasis. Treatment resulted in complete resolution within two weeks.


• Case 2: A 50-year-old female with stage 3 CKD (serum creatinine: 2 mg/dL) presented with a de-papillated tongue. Oral hygiene improvement and nutritional support addressed the issue effectively.


• Case 3: A 24-year-old female with end-stage renal disease (serum creatinine: 6 mg/dL) developed ANUG. A combination of scaling, root planing, debridement, and antibiotic therapy successfully managed the condition.

Conclusion: CKD patients are susceptible to various oral complications due to systemic immunosuppression and treatment-related side effects. Timely dental evaluation and management are essential to prevent oral health deterioration in these individuals. A multidisciplinary approach, involving both nephrologists and dental professionals, is vital for improving overall patient outcomes.