Abstract
To characterize the oropharyngeal swallowing profile of patients with chronic renal failure. A cross-sectional clinical study involving 20 adults diagnosed with chronic renal failure in hospital stay was conducted. The evaluation of swallowing was performed by videofluoroscopy, and characterization of findings was based on effectiveness and safety parameters. Functional Oral Intake Scale (FOIS) was also applied. On videofluoroscopy, 16 patients presented changes in oral and pharyngeal patterns, three individuals presented impairment at the pharyngeal phase, and only one individual presented changes only at the oral phase of swallowing. Furthermore, videofluoroscopy showed penetration and tracheal aspiration in 30% of the sample. Before the videofluoroscopy, four individuals (20%) were at level 5 of FOIS scale, whereas 16 individuals (80%) were at level 7. After adjustments of the oral diet consistency because of safety and swallowing effectiveness, FOIS classification was six individuals at level 1, seven at level 4, four at level 5, and three at level 6. The characterization of oropharyngeal swallowing profile in chronic renal patients showed abnormalities at oral and pharyngeal phase, including penetration and tracheal aspiration, which requires oral intake changes.
Highlights
The mechanisms involved in chronic renal failure (CRF) are not clear yet, patients with CRF may present, in addition to the inflammatory process, changes in regulation of the hypothalamic pituitary gland, the immune system, sleep patterns, mood, and swallowing, and the occurrence of symptoms depend on the disease, dietary habits, and the level of reduction in renal function[1,2,3,4]
Because CRF is a condition that leads to levels of consciousness change and xerostomia[4], the investigation of the hypothesis that patients may present oropharyngeal dysphagia is justified
The research on the biomechanics of swallowing is cases of CRF aims to contribute to the understanding of causes and consequences of various clinical symptoms known to be related to dysphagia, besides raising the possible need and targeting of early intervention with regard to safety and effectiveness of swallowing in this population
Summary
The mechanisms involved in chronic renal failure (CRF) are not clear yet, patients with CRF may present, in addition to the inflammatory process, changes in regulation of the hypothalamic pituitary gland, the immune system, sleep patterns, mood, and swallowing, and the occurrence of symptoms depend on the disease, dietary habits, and the level of reduction in renal function[1,2,3,4].Because swallowing is a complex act that requires the integrity of various neuronal systems involved in the integration of stimuli, central nervous system and motor response[5], any conditions affecting this integration can lead to dysphagia. Because CRF is a condition that leads to levels of consciousness change and xerostomia[4], the investigation of the hypothesis that patients may present oropharyngeal dysphagia is justified. Despite the clinical observation of abnormalities in oropharyngeal swallowing of patients with CRF during hospital stay, this phenomenon has not yet been scientifically investigated. One study, using a structured questionnaire addressed oral symptoms in CRF, pointing xerostomia[4] as main complaint and on clinical evaluation, which is relevant, as this is a predictive factor for oropharyngeal dysphagia[6]. The objective of this study was to describe the oropharyngeal swallowing profile of patients with CRF
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