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NDT Advance Access originally published online on March 17, 2009
Nephrology Dialysis Transplantation 2009 24(8):2439-2445; doi:10.1093/ndt/gfp101
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© The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


The correlation between dental calculus and disturbed mineral metabolism in paediatric patients with chronic kidney disease

Esti Davidovich1,*, Miriam Davidovits2,3*, Benny Peretz4, Joseph Shapira1 and Doron J. Aframian5

1 Department of Pediatric Dentistry, Hebrew University, Hadassah Faculty of Dental Medicine, Jerusalem 2 Institute of Paediatric Nephrology, Schneider Children's Medical Center of Israel, Petah Tiqva, Israel 3 Sackler School of Medicine, Tel Aviv University 4 Department of Pediatric Dentistry, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 5 Department of Oral Medicine, Salivary Gland Clinic, The Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel

Correspondence and offprint requests to: Doron J. Aframian; E-mail: dorona{at}cc.huji.ac.il



  Abstract

Background. Vascular calcifications have been documented in children with end-stage renal disease. However, only a few reports have described abundant dental calculus formation in children suffering from chronic kidney disease (CKD). Moreover, dental calculus scores (DCS) and their correlation with renal disease severity have not been studied.

Methods. DCS in 74 young CKD patients were evaluated: 25 pre-dialytic (PrD), 18 on dialysis (D) and 31 with transplants (T) compared to 32 healthy participants (C). Saliva and serum analysis included creatinine (Cr), urea (U), calcium (Ca), phosphorous (P), magnesium (Mg) as well as intraoral pH levels.

Results. All patient groups presented high DCS. DCS and pH levels were higher in the D group with a positive correlation between pH and lower incisor DCS (r = 0.56, P = 0.017). The highest salivary Ca was found in the PrD group. Salivary P in the PrD group was found to be higher than in the T and C groups. The lowest salivary Mg was found in the D group while the highest salivary Ca x P product was found in the PrD group. In all patient groups, salivary U was higher than in the C group with a 2.5-fold increase in the D group. Salivary Cr resembled the U salivary concentrations.

Conclusions. Alterations in salivary Ca, P, Mg, U, Cr and intraoral pH levels were observed in the patient groups. DCS correlated with renal disease severity and therefore may be a reflection of other tissue calcification pathologies found in these patients.

Keywords: Ca x P product; chronic kidney disease; dental calculus; saliva; vascular calcifications

* Both these authors contributed equally to the study.

Received for publication: 11. 6.08
Accepted in revised form: 19. 2.09


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