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Review
. 2022 May 10;14(10):2002.
doi: 10.3390/nu14102002.

The Impact of Chronic Kidney Disease on Nutritional Status and Its Possible Relation with Oral Diseases

Micaela Costacurta  1 , Michele Basilicata  2 , Giulia Marrone  3 , Manuela Di Lauro  3 , Vincenzo Campolattano  4 , Patrizio Bollero  4 , Raffaella Docimo  1 , Nicola Di Daniele  3 , Annalisa Noce  3
Affiliations
Review

The Impact of Chronic Kidney Disease on Nutritional Status and Its Possible Relation with Oral Diseases

Micaela Costacurta et al. Nutrients. .

Abstract

Several studies have demonstrated a strong relation between periodontal diseases and chronic kidney disease (CKD). The main mechanisms at the base of this link are malnutrition, vitamin dysregulation, especially of B-group vitamins and of C and D vitamins, oxidative stress, metabolic acidosis and low-grade inflammation. In particular, in hemodialysis (HD) adult patients, an impairment of nutritional status has been observed, induced not only by the HD procedures themselves, but also due to numerous CKD-related comorbidities. The alteration of nutritional assessment induces systemic manifestations that have repercussions on oral health, like oral microbiota dysbiosis, slow healing of wounds related to hypovitaminosis C, and an alteration of the supporting bone structures of the oral cavity related to metabolic acidosis and vitamin D deficiency. Low-grade inflammation has been observed to characterize periodontal diseases locally and, in a systemic manner, CKD contributes to the amplification of the pathological process, bidirectionally. Therefore, CKD and oral disease patients should be managed by a multidisciplinary professional team that can evaluate the possible co-presence of these two pathological conditions, that negatively influence each other, and set up therapeutic strategies to treat them. Once these patients have been identified, they should be included in a follow-up program, characterized by periodic checks in order to manage these pathological conditions.

Keywords: chronic kidney disease; high-protein diet; hypovitaminosis; low-grade inflammation; metabolic acidosis; periodontal diseases; protein-energy wasting.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Link between ESRD and oral diseases, in adults. Abbreviations: ESRD, end-stage renal disease, ↑ increase, ↓ decrease.
Figure 2
Figure 2
Article search methodology.
Figure 3
Figure 3
Main causes of vitamin deficiency in hemodialysis patients. ↑increase, ↓ decrease. HD: hemodialysis.
See this image and copyright information in PMC

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