Abstract | Cilj istraživanja: Cilj ovog istraživanja jest ispitati oralnohigijenske navike i kvalitetu života povezanu s oralnim zdravljem u bolesnika liječenih hemodijalizom (HD) i peritonejskom dijalizom (PD) te istražiti postoje li razlike između dvije skupine ispitanika.
Materijali i metode: U istraživanje su uključena 62 bolesnika liječena HD i 24 bolesnika liječena PD. Svim ispitanicima zabilježeni su: dob, spol, navike pušenja, postojanje šećerne bolesti, arterijske hipertenzije i biokemijski parametri. Za sve ispitanike zabilježeni su i podaci o oralnohigijenskim navikama koje uključuju učestalost i vremensko trajanje pranja zubi, korištenje različitih sredstava za održavanje oralne higijene, te prisutnost ili odsutnost pojedinih simptoma u usnoj šupljini kao što su krvarenje prilikom četkanja, neugodan zadah, bol i osjetljivost te klimanje i pomicanje zubi. Utjecaj oralnog zdravlja na kvalitetu života bolesnika liječenih HD i PD procjenjen je pomoću OHIP-14 upitnika.
Rezultati: Bolesnici liječeni HD značajno su stariji od bolesnika liječenih PD (p < 0,001). Bolesnici liječeni HD imaju statistički značajno višu serumsku razinu albumina (p<0,001), kalija (p < 0,001) te razinu MVC (engl. mean cellular volume) (p=0,004), dok bolesnici liječeni PD imaju značajno više razine kolesterola (p=0,001), LDL (engl. low-density lipoprotein) kolesterola (p=0,006) te natrija (p<0,001). Jednom do dva puta dnevno zube pere 9 (40,91%) ispitanika liječenih PD i 33 (53,93%) ispitanika liječena HD. Bolesnici liječeni PD učestalije odlaze k doktoru dentalne medicine u odnosu na bolesnike liječene HD (p=0,014). Prisutnost parodontitisa u obiteljskoj anamnezi navela su 2 (9,09%) ispitanika liječena PD, te 14 (22,58%) ispitanika liječena HD (p<0,001). Viša pojavnost simptoma neugodnog zadaha zabilječena je kod bolesnika liječenih PD (59,09%), u odnosu na bolesnike liječene HD (30,65%), p = 0,035. Srednja vrijednost zbroja OHIP-14 vrijednosti iznosila je 7,5 za bolesnike liječene HD i 4,5 za bolesnike liječene PD. U skupini bolesnika liječenih HD utvrđena je povezanost između zbroja OHIP-14 vrijednosti, serumske razine LDL kolesterola, prisutnosti parodontitisa u obiteljskoj anamnezi i simptoma klimanja i pomicanja zubi. Postoje spolne razlike u zbroju OHIP-14 vrijednosti kod bolesnika liječenih HD i PD.
Zaključak: Rezultati istraživanja ukazuju kako je kvaliteta života ovisna o oralnom zdravlju bolesnika liječenih dijalizom iznenađujuće dobra unatoč lošoj oralnoj higijeni i zanemarivanju oralnog zdravlja Daljnja istraživanja koja uključuju mjerenje kliničkih parametara u usnoj šupljini potrebna su za uvid u cjelokupno oralno zdravlje ove skupine bolesnika. |
Abstract (english) | Objectives: The aim of this study was to examine the oral hygiene habits and oral health related quality of life of patients undergoing HD and PD, as well as investigating whether there are differences between the two groups.
Materials and methods: 62 patients undergoing HD and 24 patients undergoing PD were included in the study. Information about the age, sex, smoking habits, the presence of diabetes mellitus and hypertension were collected as well as biochemical parameters. For all study subjects, data on oral hygiene habits were recorded, which include toothbrushing frequency and duration, the use of various oral hygiene products, and the presence or absence of certain symptoms in the oral cavity such as bleeding when brushing, halitosis, pain, sensitivity and loose teeth. The impact of oral health on the quality of life of patients undergoing HD and PD was assessed using the OHIP-14 questionnaire.
Results: Patients undergoing HD were significantly older than patients undergoing PD (p <0.001). Patients undergoing HD had higher serum levels of albumin (p <0.001), potassium (p <0.001) and higher levels of MVC (engl. mean cellular volume) (p = 0.004), while patients undergoing PD had significantly higher levels of cholesterol (p = 0.001), LDL (engl. low-density lipoprotein) cholesterol (0.006) and sodium (p <0.001). 9 (40.91%) subjects undergoing PD and 33 (53.93%) subjects undergoing HD brushed their teeth once or twice a day. Patients undergoing PD are visiting the dentist more often compared to patients undergoing HD (p = 0.014). The presence of periodontitis in the family history was stated by 2 (9.09%) subjects undergoing PD, and 14 (22.58%) subjects undergoing HD (p <0.001). A higher incidence of halitosis was observed in patients undergoing PD (59.09%), compared to patients undergoing HD (30.65%), p = 0.035. The mean sum of OHIP-14 values was 7.5 for patients undergoing HD and 4.5 for patients undergoing PD. In the group of patients undergoing HD, an association was found between the sum of OHIP-14 values, serum LDL cholesterol levels, the presence of a family history of periodontitis, and symptoms of nodding and moving teeth. There are gender differences in the sum of OHIP-14 values in patients treated with HD and PD.
Conclusion: The results of the study indicate that the oral health related quality of life of dialysis patients is surprisingly good despite their poor oral hygiene and neglection of oral health. Further research that involves measurement of clinical parameters in the oral cavity is required to gain insight into overall oral health of dialysis patients. |