Abstract
Objectives: Oral candidiasis (OC) is a frequent oral lesion in renal transplant patients (RTPs). Despite the increased prevalence of OC in RTPs, no study has examined related risk factors. The aims of this study were to analyze the prevalence of and risk factors for OC in RTPs compared with age- and gender-matched healthy control group (HC) as well as determine the incidence of OC after transplantation. Study Design: We analyzed the prevalence and risk factors of OC in a group of 500 RTPs (307 men, 193 women, mean age 53.63 years) and 501 HC subjects (314 men, 187 women, mean age 52.25 years). Demographic and pharmacological data were recorded for all subjects. Incident cases of OC were ascertained retrospectively from outpatient clinical records only in the RTP group. Results: The prevalence of OC was 7.4% in RTPs compared with 4.19% in HC (P<0.03). The most frequent type of OC in the two groups was denture stomatitis. Statistical association was found between OC and age, mycophenolate mofetil dose and blood levels, dentures and tobacco. The multiple logistic regression model only chose for denture variable. According to the outpatient clinical records, 24 RTPs suffered OC during the first moth post-transplant. Severe lesions affecting the oral cavity and pharynx appeared in 79% of the OC cases. Conclusions: This study shows a lower prevalence of OC in RTPs than previous reports. Denture stomatitis was the most frequent OC prevalence form described in RTPs. Severe candidiasis is more frequent in the immediate posttransplant period. The presence of denture is an important risk factor of OC. These results emphasise the importance of adequate pre- and post-transplant oral health and denture cleaning and adjustment is recommended for these subjects to prevent this infection. Key words:Oral candidiasis, immunosuppressive therapy, renal transplantation.
Highlights
Solid-organ transplantation is a globally accepted procedure for patients with irreversible organ failure
Previous studies have shown that renal transplant patients (RTPs) have considerably higher prevalence of Oral candidiasis (OC) than healthy controls (HCs), and this condition is the most frequent oral infection in RTPs, with a prevalence ranging between 7.7% and 46.7% [8,9,10,11,12,13]
OC appeared in 85.2% of the RTPs and 61.1% of the HCs who wore acrylic dentures as well as in 14.8% of the RTPs and 22.2% of the HCs who wore metallic dentures
Summary
Solid-organ transplantation is a globally accepted procedure for patients with irreversible organ failure This therapy is associated with different side-effects and the necessary immunosuppression leads to increased rates of infection, malignancy, and other complications [1,2,3]. Some studies suggested that oral infections, including candidiasis, are more severe in the immediate posttransplantation period [4,5], but cross-sectional studies of OC in RTPs did not support this finding [8,9,10,11,12,13] In this sense, a longitudinal design would be more reliable to analyze whether OC is more common in the immediate posttransplantation period and study its associated factors. The aims of this study were to analyze the prevalence of and risk factors for OC in RTPs compared with age- and gender-matched HCs as well as determine the incidence of OC after transplantation
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