Prevalência de lesões orais e alterações salivares em pacientes com insuficiência renal crônica em hemodiálise: revisão sistemática e metanálise

Abstract

In addition to changes in salivary flow and composition, chronic renal failure (CRF) can lead to several oral manifestations, which are secondary to systemic manifestations, such as: periodontal disease (PD), mucosal lesions, oral infections, among others. Objective: To evaluate which are the most common salivary and oral mucosa alterations in individuals with chronic renal failure. Materials and methods: A systematic review of the literature was carried out, evaluating randomized clinical trials in the following databases: Proquest, Embase, Scopus, Cochrane Library, Web of Science, Lilacs and Pubmed, using MeSH terms and others. From the initial search, 6,445 studies were obtained, whose title and abstract were analyzed by two independent reviewers, with 15 articles that analyzed oral lesions and salivary alterations in patients with CRF undergoing hemodialysis treatment being included in the study. Results: Most clinical studies included were cross-sectional and all consisted of a study group and a healthy control group. The mean age of all participants in the study group was 50.19 years and in the control group it was 48.95 years. In both groups there were both male and female people. The oral alterations most found in the CRF group compared to the control group were: xerostomia, uremic breath, dysgeusia, coated tongue, gingival bleeding and pale mucosa. The salivary flow of patients with CRF was also lower, since saliva production was 46.6% lower in the test group. Salivary pH in the study group was also more alkaline when compared to the control group. Higher amounts of urea, phosphate, C-reactive protein, total proteins and creatinine were also found in the saliva of individuals with CRI. Conclusion: individuals with CRF undergoing hemodialysis are more prone to alterations in both the quantity and quality of saliva, as well as having a greater number of oral alterations.