구강회복응용과학지 (Journal of Dental Rehabilitation and Applied Science)

  • 제40권2호
  • /
  • Pages.46-54
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  • 2024
  • /
  • 2384-4353(pISSN)
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  • 2384-4272(eISSN)
대한턱관절교합학회 (Korean Academy of Stomatognathic Function and Occlusion)
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투석을 받고 있으며 신장 이식 수술 전 구강내 평가를 위해 의뢰된 말기 신장 질환 자의 치주 상태

Periodontal status of end-stage renal disease patients undergoing dialysis and referred for intraoral evaluation prior to kidney transplant surgery

  • 최윤경 (부산대학교병원 치과진료센터) ;
  • 전혜미 (부산대학교병원 치과진료센터) ;
  • 주지영 (부산대학교 치의학전문대학원 치주과학교실) ;
  • 김현주 (부산대학교 치의학전문대학원 치주과학교실) ;
  • 권은영 (부산대학교병원 치과진료센터)
  • Youn-Kyung Choi (Dental Clinic Center, Pusan National University Hospital) ;
  • Hye-Mi Jeon (Dental Clinic Center, Pusan National University Hospital) ;
  • Ji-Young Joo (Department of Periodontology, School of Dentistry, Pusan National University) ;
  • Hyun-Joo Kim (Department of Periodontology, School of Dentistry, Pusan National University) ;
  • Eun-Young Kwon (Dental Clinic Center, Pusan National University Hospital)
  • 투고 : 2023.12.29
  • 심사 : 2024.02.13
  • 발행 : 2024.05.31
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초록

목적: 투석을 받고 있으며 신장 이식 수술 전 구내 평가를 위해 의뢰된 말기 신장 질환자의 치주 상태를 신장 기능이 정상인 대상자들과 비교 평가하고자 함이다. 연구 재료 및 방법: 말기 신장 질환으로 투석을 받고 있으면서 신장 이식 수술 전 구강내 평가를 위해 대학병원 신장 내과에서 치과진료센터로 의뢰된 환자들을 대상으로 하였다. 치주 상태의 비교를 위해 신장 기능에 이상이 없으면서, 나이와 성별이 부합하는 대상자를 추출하여 건강한 대조군으로 선정하였다. 신장내과 진료 기록을 통해 환자의 연령, 성별, 동반질병, 받고 있는 투석의 종류, 투석 기간을 조사하였으며, 치주과 진료 기록을 통해 치주 상태에 대한 자료를 분석하였다. 결과: 투석을 받는 환자 51명 및 건강한 대조군에 속한 51명을 합하여 모두 102명이 본 연구에 포함되었다. 신장 이식 수술을 받기 전까지 투석을 받은 말기 신장 질환자들에서 건강한 대상자들에 비해 치주낭 깊이, 임상적 부착수준, 치주낭 깊이가 5 mm 이상 되는 부위의 백분율, 임상적 부착수준이 4 mm 이상 되는 부위의 백분율, 탐침시 출혈이 일어나는 치아의 백분율, 상실치 수 등이 유의하게 크게 나타났다. 또한 투석을 받는 환자 그룹에서 중등도에서 중도 치주염을 지닌 비율이 건강한 대조군에 비해 더 높은 것으로 나타났다. 결론: 본 연구에서 투석을 받고 있으며 신장 이식 수술 전 구강내 평가를 위해 의뢰된 말기 신장 질환자의 치주 상태는 연령과 성별이 유사한 건강한 대조군에 속한 대상자들에 비해 악화된 상태였다.

Purpose: The purpose of this study was to compare the periodontal status of end-stage renal disease patients undergoing dialysis and referred for intraoral evaluation prior to renal transplantation surgery with those having normal kidney function. Materials and Methods: Patients who had been undergoing dialysis for end-stage renal disease and been referred to the Dental Clinic Center by the Department of Nephrology at University Hospital for intraoral evaluation prior to kidney transplantation surgery. For comparison of periodontal status, subjects without abnormalities in kidney function were matched with the patients by age and gender and selected as healthy controls. The patients' age, gender, comorbidities, type of dialysis received, and duration of dialysis were investigated by reference to their medical records, and data on their periodontal status were analyzed via the relevant periodontal records. Results: A total of 102 patients, including 51 dialyzed patients and 51 healthy control group subjects, participated in this study. In the patients with end-stage renal disease undergoing dialysis with periodontal probing depth of 5 mm or more, percentage of sites with clinical attachment level of 4 mm or more, percentage of teeth with bleeding on probing, number of missing teeth, and ratio of moderate to severe periodontitis were all significantly greater than in the healthy controls. Conclusion: The periodontal status of end-stage renal disease patients undergoing dialysis and referred for intraoral evaluation prior to kidney transplantation was worse than that of healthy controls.

키워드

과제정보

This work was supported by clinical research grant from Pusan National University Hospital in 2023.

참고문헌

  1. Nylund KM, Meurman JH, Heikkinen AM, Furuholm JO, Ortiz F, Ruokonen HM. Oral health in patients with renal disease: a longitudinal study from predialysis to kidney transplantation. Clin Oral Investig 2018;22:339-47.
  2. Dannewitz B, Sommerer C, Stolzel P, Baid-Agrawal S, Nadal J, Barthlein B, Wanner C, Eckardt KU, Zeier M, Schlagenhauf U, Krane V, Jockel-Schneider Y. Status of periodontal health in German patients suffering from chronic kidney disease - Data from the GCKD study. J Clin Periodontol 2020;47:19-29.
  3. Guzeldemir E, Toygar HU, Tasdelen B, Torun D. Oral health-related quality of life and periodontal health status in patients undergoing hemodialysis. J Am Dent Assoc 2009;140:1283-93.
  4. Vanholder R, De Smet R, Glorieux G, Argiles A, Baurmeister U, Brunet P, Clark W, Cohen G, De Deyn PP, Deppisch R, Descamps-Latscha B, Henle T, Jorres A, Lemke HD, Massy ZA, PasslickDeetjen J, Rodriguez M, Stegmayr B, Stenvinkel P, Tetta C, Wanner C, Zidek W. Review on uremic toxins: Classification, concentration, and interindividual variability. Kidney Int 2003;63:1934-43.
  5. Schmalz G, Kollmar O, Vasko R, Muller GA, Haak R, Ziebolz D. Oral health-related quality of life in patients on chronic haemodialysis and after kidney transplantation. Oral Dis 2016;22:665-72.
  6. Bayraktar G, Kurtulus I, Kazancioglu R, Bayramgurler I, Cintan S, Bural C, Bozfakioglu S, Besler M, Trablus S, Issever H, Yildiz A. Evaluation of periodontal parameters in patients undergoing peritoneal dialysis or hemodialysis. Oral Dis 2008;14:185-9.
  7. Ausavarungnirun R, Wisetsin S, Rongkiettechakorn N, Chaichalermsak S, Udompol U, Rattanasompattikul M. Association of dental and periodontal disease with chronic kidney disease in patients of a single, tertiary care centre in Thailand. BMJ Open 2016;6:e011836.
  8. Schmalz G, Kauffels A, Kollmar O, Slotta JE, Vasko R, Muller GA, Haak R, Ziebolz D. Oral behavior, dental, periodontal and microbiological findings in patients undergoing hemodialysis and after kidney transplantation. BMC Oral Health 2016;16:72.
  9. Craig RG. Interactions between chronic renal disease and periodontal disease. Oral Dis 2008;14:1-7.
  10. Marakoglu I, Kahraman Gursoy U, Demirer S, Sezer H. Periodontal status of chronic renal failure patients receiving hemodialysis. Yonsei Med J 2003;44:648-52.
  11. Castillo A, Mesa F, Liebana J, Garcia-Martinez O, Ruiz S, Garcia-Valdecasas J, O'Valle F. Periodontal and oral microbiological status of an adult population undergoing haemodialysis: A cross-sectional study. Oral Dis 2007;13:198-205.
  12. Naugle K, Darby ML, Bauman DB, Lineberger LT, Powers R. The oral health status of individuals on renal dialysis. Ann Periodontol 1998;3:197-205.
  13. de Souza CM, Braosi APR, Luczyszyn SM, Olandoski M, Kotanko P, Craig RG, Trevilatto PC, Pecoits-Filho R. Association Among Oral Health Parameters, Periodontitis, and Its Treatment and Mortality in Patients Undergoing Hemodialysis. J Periodontol 2014;85:e169-78.
  14. Page RC, Eke PI. Case Definitions for Use in Population-Based Surveillance of Periodontitis. J Periodontol 2007;78(7 Suppl):1387-99.
  15. Ismail G, Dumitriu HT, Dumitriu AS, Ismail FB. Periodontal disease: A covert source of inflammation in chronic kidney disease patients. Int J Nephrol 2013;2013:515796.
  16. Chhokra M, Manocha S, Dodwad V, Gupta U, Vaish S. Establishing an association between renal failure and periodontal health: A cross sectional study. J Clin Diagn Res 2013;7:2348-50.
  17. Duran I, Erdemir EO. Periodontal treatment needs of patients with renal disease receiving haemodialysis. Int Dent J 2004;54:274-8.
  18. Grubbs V, Vittinghoff E, Beck JD, Kshirsagar AV, Wang W, Griswold ME, Powe NR, Correa A, Young B. Association Between Periodontal Disease and Kidney Function Decline in African Americans: The Jackson Heart Study. J Periodontol 2015;86:1126-32.
  19. Page RC. The pathobiology of periodontal diseases may affect systemic diseases: inversion of a paradigm. Ann Periodontol 1998;3:108-20.
  20. Ioannidou E, Shaqman M, Burleson J, DongariBagtzoglou A. Periodontitis case definition affects the association with renal function in kidney transplant recipients. Oral Dis 2010;16:636-42.
  21. Zwiech R, Bruzda-Zwiech A. Does oral health contribute to post-transplant complications in kidney allograft recipients? Acta Odontol Scand 2013;71:756-63.
  22. Nunes-dos-Santos DL, Gomes SV, Rodrigues VP, Pereira ALA. Periodontal status and clinical outcomes in kidney transplant recipients: A systematic review. Oral Dis 2020;26:22-34.
  23. Ebersole JL, Machen RL, Steffen MJ, Willmann DE. Systemic acute-phase reactants, C-reactive protein and haptoglobin, in adult periodontitis. Clin Exp Immunol 1997;107:347-52.
  24. Papapanou PN, Sanz M, Buduneli N, Dietrich T, Feres M, Fine DH, Flemmig TF, Garcia R, Giannobile WV, Graziani F, Greenwell H, Herrera D, Kao RT, Kebschull M, Kinane DF, Kirkwood KL, Kocher T, Kornman KS, Kumar PS, Loos BG, Machtei E, Meng H, Mombelli A, Needleman I, Offenbacher S, Seymour GJ, Teles R, Tonetti MS. Periodontitis: Consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol 2018;89 Suppl 1:S173-S182.