Oral health-related quality of life in adult patients with end-stage kidney diseases undergoing renal replacement therapy \u2013 a systematic review

Gerhard Schmalz,Susann Patschan,Dirk Ziebolz,Daniel Patschan

doi:10.1186/s12882-020-01824-7

Gerhard Schmalz, Susann Patschan + Show 2 more

Open Access

https://doi.org/10.1186/s12882-020-01824-7

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Journal: BMC Nephrology	Publication Date: Apr 29, 2020
Citations: 20	License type: open-access

Affiliation: Leipzig University, Klinikum Brandenburg

Abstract

BackgroundThe oral health of patients undergoing renal replacement therapy (RRT) is insufficient. Poor oral health and its components can affect the oral health-related quality of life (OHRQoL) of these patients. The aim of this systematic review was to assess the OHRQoL of adult patients under RRT.MethodsA systematic literature search was performed using the terms: dialysis OR “renal disease” OR kidney OR “renal failure” OR “kidney transplantation” OR hemodialysis OR “peritoneal dialysis” OR “renal replacement therapy” AND “oral health-related quality of life”, complemented by manual search. Clinical studies including adults (age ≥ 18 years) that were published between 2009 and 2019 were included in qualitative analysis.ResultsTwelve out of 20 studies were included in the qualitative analysis. The majority (11/12 studies) included patients undergoing haemodialysis (HD), with a sample size between 47 and 512 participants. Two studies included patients after kidney transplantation. Only one-quarter of the investigations included a healthy control group. The overall OHRQoL was found to be reduced. The majority of studies found relationships between OHRQoL and different oral health parameters. Furthermore, several relationships between OHRQoL and general quality of life as well as disease related parameters including age, gender, diabetes, blood parameters and dialysis duration were found. OHRQoL subscales psychological/psychosocial impairment and pain were predominantly affected.ConclusionsPatients under RRT suffer from a reduced OHRQoL, which is potentially influenced by oral health and disease related parameters. Interdisciplinary dental care is needed and should consider both physical and psychosocial issues.

Highlights

The oral health of patients undergoing renal replacement therapy (RRT) is insufficient
A systematic search was performed in January 2020 based on the PubMed database using the following search terms: dialysis OR “renal disease” OR kidney OR “renal failure” OR “kidney transplantation” OR hemodialysis OR “peritoneal dialysis” OR “renal replacement therapy” AND “oral health-related quality of life”
Three studies were excluded during screening; in one case, the type of article was the reason, and in two cases, the publication time was before the examination period

Summary

Introduction

The oral health of patients undergoing renal replacement therapy (RRT) is insufficient. A specific part of HRQoL with respect to the oral cavity is defined: the oral health-related quality of life (OHRQoL) [8]. This OHRQoL is a multidimensional model that provides information of the subjectively perceived influence of oral health conditions on patients’ oral function, pain, psychosocial impact and orofacial appearance [9]. Patients with end-stage renal diseases, especially those receiving HD on a regular basis, suffer from an insufficient oral health status and oral behaviour [10]. A reduced OHRQoL caused by this increased prevalence of oral diseases is conceivable

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