title: Oral and salivary changes in patients with chronic kidney disease: A clinical and biochemical study.
abstract: BACKGROUND
  Both chronic kidney disease (CKD) and its treatment can affect a wide range of tissues and systems. It directly or indirectly affects flow, concentrations and composition of saliva. Hemodialysis can effectively minimize most of these complications to some extent.
  
  
  OBJECTIVE
  The main aim of this study was to know the salivary content of sodium, potassium, calcium, urea, bicarbonate and oral manifestations in patients with CKD.
  
  
  METHODS
  For this study, 50 patients diagnosed with CKD and 50 systemically and periodontally healthy individuals were subjected to a detailed general and intraoral examination. Whole un-stimulated saliva samples of all the selected subjects were collected and subjected to calcium (Ca), phosphorous (P), sodium (Na), potassium (K), bicarbonate and urea analysis.
  
  
  METHODS
  Paired t-test, Mann-Whitney test.
  
  
  RESULTS
  Among 50 study subjects, 26 subjects had reduced salivary flow in the range of 0.1-0.4 ml/min. Intraoral examination of the study subjects revealed pallor, increased deposition of calculus, bleeding gums, metallic taste, hypoplasia of teeth and fissured tongue. There was a significant difference between healthy and prehemodialysis patients in the salivary sodium, potassium, calcium, phosphorus, urea levels and the difference was insignificant in relation to bicarbonate levels.
  
  
  CONCLUSIONS
  Alterations in salivary calcium, phosphorous, urea, sodium, potassium levels were significantly higher in the study groups when compared to control groups and the difference was insignificant in relation to bicarbonate level. The increased levels in dialysis patients correlated with renal disease severity.
authors.affiliation: Department of Periodontics, MNR Dental College and Hospital, Sangareddi, Telangana, India.
authors.forename: Beela Ram
authors.initials: BR
authors.lastname: Anuradha
authors.affiliation: Department of Oral Medicine and Radiology, Lenora Institute of Dental Sciences, Rajahmundry, Andhra Pradesh, India.
authors.forename: Sudheer
authors.initials: S
authors.lastname: Katta
authors.affiliation: Department of Periodontics, MNR Dental College and Hospital, Sangareddi, Telangana, India.
authors.forename: Venkata Satyanarayana
authors.initials: VS
authors.lastname: Kode
authors.affiliation: Department of Prosthodontics, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India.
authors.forename: Channamsetty
authors.initials: C
authors.lastname: Praveena
authors.affiliation: Department of Conservative Dentistry and Endodontics, St. Joseph Dental College, Eluru, Andhra Pradesh, India.
authors.forename: Naresh
authors.initials: N
authors.lastname: Sathe
authors.affiliation: Department of Prosthodontics, SVS Institute of Dental Sciences, Mahbubnagar, Telangana, India.
authors.forename: Nalla
authors.initials: N
authors.lastname: Sandeep
authors.affiliation: Department of Periodontics, MNR Dental College and Hospital, Sangareddi, Telangana, India.
authors.forename: Swati
authors.initials: S
authors.lastname: Penumarty
keywords: Chronic renal failure; hemodialysis; saliva