RENAL DISEASE

BY: Tara King

Hollie Schroeder
Rachel Musselwhite

What Is Renal Disease?

Kidneys have multiple functions including

filtering blood, removing wastes and extra
water to make urine, control blood
pressure, and make hormones to make
sure body stays healthy
Renal disease: Is when the kidneys are
damaged allowing waste to build up in the
body.
There is chronic Kidney disease, Acute
Kidney disease, and Kidney Failure

Causes of Renal Disease

Many things can cause Renal

disease main risk factors include
Diabetes
High blood pressure
Cardiovascular disease
Family history of kidney failure

Population

More than 20 million Americans have

Renal disease and many more are at
risk.
Anyone can develop Renal disease
regardless of age or race.

Treatment of Renal
Disease

If it is detected early can treat with

medications such as ACE inhibitors and
ARBs
Treatment of Kidney Failure includes
Dialysis or a kidney transplant

Indications and Contraindications

Indications:
Patients receiving dialysis are more prone to periodontal disease
Contraindications:
Dialysis patients-herparinized so in order to avoid abnormal
bleeding tendencies, treatment should be done the day after
dialysis
Transplant patients, only emergency treatment should be carried
out within the 1st three months after transplantation
General anesthesia
Topical fluoride applications need to be used carefully
Medications: antimicrobials, analgesics, hypnotics may need to be
given in lower doses

Oral Health with Renal Disease

Xerostomia:

main oral health problem experienced

Plaque & Calculus formed more rapidly
Significant correlation between plaque scores & gingival inflammation
Elevated parathyroid hormone synthesis cause accelerated bone loss
Halitosis & unpleasant metallic taste
Burning sensation in the lips & tongue
Bleeding tendencies
Dialysis

duration significantly correlates with gingivitis, probing depth,

attachment loss, & enamel hypoplasia

Kidney-transplanted

patients effects:
Susceptible to injection
Malignant neoplasms
Gingival overgrowth
Candida albicans
Angular cheilitis

Medical Treatment and

medications

If on dialysis, dental treatment should

occur within 24 hours of dialysis.
Patients with shunts, may be taking a
blood thinner, which increases the risk of
bleeding and hemorrhage.
Calculus is formed rapidly because of
high salivary urea & neglect
Xerostomia

Periodontal Management

Consult with physician

Depends on the severity, a blood test may be
requested before invasive dental procedures
Eliminate potential sources of infection/bacteremia
Use adjunctive hemostatic aids during
oral/periodontal surgical procedures
Use postsurgical hemostatic agents
Encourage meticulous home care
Provide therapy for xerostomia when appropriate
Dentist should pay close attention to the
medications prescribed

Pre Med

Patients should consult with their doctor before any dental

treatment because pre med is required
- Patient on dialysis
- Patient with a shunt
- Patient with a organ transplant
Transplant patients should receive antibiotic prophylaxis prior
to dental treatment
- Extremely sensitive to infections
- Oral infections may bring about rejection of the organ
Penicillin or Cephalosporin are usually administered
- Should ask to make sure not allergic to penicillin because
allergies to penicillin are quiet common.

Dental Treatment
Patient may demonstrate increased periodontal
disease, caries, ulcerations from medications,
halitosis, and bleeding tendency
In endodontic patients treatment of the
deciduous and multirooted teeth should be
avoided at all costs because of increase risk of
infection
Extractions should be done with local anesthetic
- Amide types
Best time for appointment : the day after dialysis

Appointment
Modifications

Ultrasonic can be used

Do not use air polisher

If patient has a shunt do no take blood pressure on

that arm

Monitor patients vitals

Frequent recalls

Dental Hygiene Care

Patient education is VERY important

Patients may be unaware of their increased risk for oral diseases

Higher periodontal disease

Patients may be pre-occupied with the treatment of their renal

disease that they may neglect preventive oral health measures

Dialysis patients form calculus more rapidly than healthy individuals

As chronic kidney disease progress their gingival and periodontal

status worsens

Nutritional counseling and palliative care for oral ulcerative lesions

Positive reinforcement

Question #1
Kidney disease is when the kidneys are
damaged and wastes can build up in the
body. The two most common risk factors
for kidney disease are diabetes and low
blood pressure
A. Both statements are true
B. Both statements are false
C. 1st statement is true and second is false
D. 1st statement is false and second is true

Question #2
The best appointment time for a patient on
dialysis is the day after; antibiotics is not
required before dental procedures on a
patient with a transplant, shunt, or dialysis.
A. Both statements are true
B. Both statements are false
C. 1st statement is true and second is false
D. 1st statement is false and second is true

Question #3
Dialysis duration significantly correlates
with all of the following EXCEPT:
a. Gingivitis
b. attachment loss
c. enamel hypoplasia
d. enamel hypocalcification

References

Kidney Disease Basics. (n.d.). Retrieved November 30, 2015, from

http://www.niddk.nih.gov/health-information/health-communicatio
n-programs/nkdep/learn/causes-kidney-disease/kidney-disease-bas
ics/Pages/kidney-diseasebasics.aspx
Kidney Disease Basics. (n.d.). Retrieved November 30, 2015, from
http://www.niddk.nih.gov/health-information/health-communicationprograms/nkdep/learn/causes-kidney-disease/kidney-diseasebasics/Pages/kidney-disease-basics.aspx
Dr. Dan Peterson: Kidney disease and oral health. Family gentle dental
care
Silvia Marti Alamo, Carmen Gavalda Esteve, M Garcia Sarrion Perez:
Dental considerations for the patient with renal disease. Journal section:
Oral medicine and Pathology. 2011; 3(2):e112-9
Robert E Rada, DDS: Oral effects of kidney disease. Dimension of dental
hygiene. 2015/01_january