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BACKGROUND: Oral disease may be increased in people with chronic kidney disease (CKD) and, due to associations with inflammation and malnutrition, represents a potential modifiable risk factor for cardiovascular disease and mortality. We summarized the prevalence of oral disease in adults with CKD and explored any association between oral disease and mortality. METHODS: We used systematic review of observational studies evaluating oral health in adults with CKD identified in MEDLINE (through September 2012) without language restriction. We summarized prevalence and associations with all-cause and cardiovascular mortality using random-effects meta-analysis. We explored for sources of heterogeneity between studies using meta-regression. RESULTS: Eighty-eight studies in 125 populations comprising 11 340 adults were eligible. Edentulism affected one in five adults with CKD Stage 5D (dialysis) 20. 6% 95% confidence interval (CI), 16. 4-25. 6. Periodontitis was more common in CKD Stage 5D 56. 8% (CI, 39. 3-72. 8) than less severe CKD 31. 6% (CI, 19. 0-47. 6), although data linking periodontitis with premature death were scant. One-quarter of patients with CKD Stage 5D reported never brushing their teeth 25. 6% (CI, 10. 2-51. 1) and a minority used dental floss 11. 4% (CI, 6. 2-19. 8) ; oral pain was reported by one-sixth 18. 7% (CI, 8. 8-35. 4), while half of patients experienced a dry mouth 48. 4% (CI, 37. 5-59. 5). Data for kidney transplant recipients and CKD Stages 1-5 were limited. CONCLUSIONS: Oral disease is common in adults with CKD, potentially reflects low use of preventative dental services, and may be an important determinant of health in this clinical setting.
Ruospo et al. (Sun,) studied this question.