Analysis of Salivary Flow, pH, Buffer Capacity, and Creatinine in Individuals Undergoing Hemodialysis

Ap Fregoneze,Mw Zanelatto,T Luzzi,Ja Brancher,Lk Guimarães,M Bönecker,Al Ortega

doi:10.4034/pboci.2016.161.15

Abstract

Objective : To quantify salivary creatinine levels patients with end-stage renal disease (ESRD) before, during, and after hemodialysis sessions. Material and Methods: Sixty-eight individuals, aged between 4 and 25 years, were selected, and among these, 34 were diagnosed with ESRD and were undergoing hemodialysis (Group 1) and 34 were clinically healthy patients (Group 2). Saliva samples were collected before, during, and after hemodialysis sessions for Group 1 and compared with those of Group 2. Stimulated saliva flow rate (SSFR), buffer capacity (BC), pH, and salivary creatinine levels were determined. Shapiro-Wilk test, followed by the Friedman, Mann-Whitney and ANOVA tests were used to analyze the variables. Results: Mean SSFR values of Group 1 at the three stages of hemodialysis sessions did not differ from those of Group 2. Furthermore, BC and pH values were within their normal limits, and no difference was detected between the two groups. Mean salivary creatinine levels at baseline and during hemodialysis were significantly higher in Group 1 that in Group 2, but these values were not different between Groups at the end of hemodialysis. Conclusion: Salivary creatinine levels reduce significantly after hemodialysis sessions suggesting that saliva may be used to monitor the efficiency of hemodialysis or even indicate the moment at which it should start.

Highlights

Saliva provides several innate and acquired defense factors that can inhibit bacterial invasion, growth, and metabolism by different mechanisms [1,2] such as bacterial adherence and streptococci acid production [3]
Salivary creatinine levels reduce significantly after hemodialysis sessions suggesting that saliva may be used to monitor the efficiency of hemodialysis or even indicate the moment at which it should start
Five of the 34 patients in the study did not participate in the analysis due to the following causes: two of the patients were unable to produce a salivary flow with stimulation, two displayed behavioral resistance, and one died before the collection date

Summary

Introduction

Saliva provides several innate and acquired defense factors that can inhibit bacterial invasion, growth, and metabolism by different mechanisms [1,2] such as bacterial adherence and streptococci acid production [3]. A constant salivary flow efficiently eliminates microorganisms from the oral cavity; a reduced flow may favor microbial growth, followed by teeth deterioration [7]. Some salivary proteins such as lysozymes, lactoperoxidase, immunoglobulins, agglutinines, mucins, and lactotransferrin have antibacterial effects [8] and help in preventing oral diseases. Salivary biomarkers are employed for screening purposes in epidemiological studies [10] and are being used to monitor and detect various oral and systemic diseases such as breast cancer [11], lung cancer [12], celiac disease [13], and chronic renal failure [14]. The list of markers included cortisol, nitrite, uric acid, sodium, chloride, pH, amylase, and lactoferrin [15]

Methods

Results

Conclusion