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ABSTRACT: Background
Chronic kidney disease is a risk factor for oral diseases, which may be associated with premature death. We evaluated the risk of all-cause and cardiovascular mortality associated with oral mucosal lesions in adults with kidney failure treated with long-term haemodialysis.Methods
Oral mucosal lesions (herpes, ulceration, neoformation, white lesion, red lesion, oral candidiasis, geographical tongue, petechial lesions, and fissured tongue) were evaluated within the Oral Diseases in Haemodialysis (ORAL-D) study, a multinational cohort study of 4726 haemodialysis adults. We conducted cox regression analyses adjusted for demographic and clinical variables to evaluate the association with all-cause and cardiovascular mortality.Results
Overall, 4205 adults (mean age 61.6 ± 15.6 years) underwent oral mucosal examination with 40% affected by at least one lesion. The prevalence of oral lesions was (in order of frequency): oral herpes 0.5%, mucosal ulceration 1.7%, neoformation 2.0%, white lesion 3.5%, red lesion 4.0%, oral candidiasis 4.6%, geographical tongue 4.9%, petechial lesions 7.9%, and fissured tongue 10.7%. During median follow-up of 3.5 years, 2114 patients died (1013 due to cardiovascular disease). No association was observed between any individual oral lesion and all-cause or cardiovascular mortality when adjusted for comorbidities, except for oral candidiasis, which was associated with all-cause mortality (adjusted hazard ratio 1.37, 95% CI 1.00 to 1.86) and cardiovascular mortality (adjusted hazard ratio 1.64, 95% CI 1.09 to 2.46).Conclusion
Oral mucosal lesions are prevalent in haemodialysis patients. Oral candidiasis appears to be a risk factor for death due to cardiovascular diseases.
SUBMITTER: Ruospo M
PROVIDER: S-EPMC6588239 | biostudies-literature | 2019
REPOSITORIES: biostudies-literature
Ruospo Marinella M Palmer Suetonia C SC Graziano Giusi G Natale Patrizia P Saglimbene Valeria V Petruzzi Massimo M De Benedittis Michele M Craig Jonathan C JC Johnson David W DW Ford Pauline P Tonelli Marcello M Celia Eduardo E Gelfman Ruben R Leal Miguel R MR Török Marietta M Stroumza Paul P Frantzen Luc L Bednarek-Skublewska Anna A Dulawa Jan J Del Castillo Domingo D Schön Staffan S Bernat Amparo G AG Hegbrant Jörgen J Wollheim Charlotta C Gargano Letizia L Strippoli Giovanni F M GFM
PloS one 20190621 6
<h4>Background</h4>Chronic kidney disease is a risk factor for oral diseases, which may be associated with premature death. We evaluated the risk of all-cause and cardiovascular mortality associated with oral mucosal lesions in adults with kidney failure treated with long-term haemodialysis.<h4>Methods</h4>Oral mucosal lesions (herpes, ulceration, neoformation, white lesion, red lesion, oral candidiasis, geographical tongue, petechial lesions, and fissured tongue) were evaluated within the Oral ...[more]