Oral symptoms and oral health-related quality of life in patients with chronic kidney disease from predialysis to posttransplantation

Clin Oral Investig. 2019 May;23(5):2207-2213. doi: 10.1007/s00784-018-2647-z. Epub 2018 Oct 2.


Objective: This prospective follow-up cohort study analyzed chronic kidney disease (CKD) patients' oral symptoms, health habits, and oral health-related quality of life (OHRQoL), from predialysis to posttransplantation. A simplified questionnaire method (Oral Health Quality Score, OHQS), based on these and clinical findings, was constructed and tested for identifying patients in need for referral to a dentist.

Material and methods: Fifty-three CKD patients were followed up for a mean of 10.3 years. Clinical oral, radiological, and salivary examination was performed at baseline and posttransplantation. Total Dental Index (TDI) indicating inflammation was calculated. The patients filled out a questionnaire on symptoms, oral hygiene and health care habits, smoking, alcohol use, and medication. General health-related quality of life was assessed with the 15-dimensional (15D) instrument at posttransplantation. Descriptive and analytical methods were used in statistics.

Results: OHQS significantly correlated with high TDI (p = 0.017), number of teeth (p = 0.031), and unstimulated salivary flow rate (p = 0.001) in transplanted patients. Number of daily medications showed a negative correlation with the OHQS (r = - 0.30; p = 0.028). The prevalence of oral symptoms was slightly, but not significantly, more common posttransplantation compared with predialysis stage.

Conclusion: OHQS identified patients with high oral inflammatory score thus confirming our study hypothesis.

Clinical relevance: Use of OHQS and measuring salivary flow indicate patients at risk for oral diseases. These markers might be easy to use chair-side also by auxiliary personnel.

Keywords: Burning mouth sensation; Kidney diseases; Oral health; Organ transplants; Self-care; Xerostomia.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Follow-Up Studies
  • Humans
  • Kidney Transplantation*
  • Male
  • Middle Aged
  • Oral Health*
  • Prospective Studies
  • Quality of Life*
  • Renal Dialysis*
  • Renal Insufficiency, Chronic / complications*
  • Renal Insufficiency, Chronic / surgery
  • Young Adult