Original investigation: dialysis therapySalivary and lacrimal secretion is reduced in patients with ESRD
Section snippets
Patients
The protocol conformed to the ethical guidelines of our institution, and informed consent was obtained from each participant.
We studied 63 patients (38 men, 25 women; mean age, 50.2 ± 13.8 [SD] years; range, 13 to 79 years) treated with long-term hemodialysis for 6.5 ± 5.2 years (range, 0.1 to 17 years). Main biochemical results for these patients are listed in Table 1. These patients represent 73% of the dialysis population treated in our hemodialysis unit. We excluded from the study patients
Saxon's test and xerostomia symptoms
On average, salivary secretion was markedly reduced in uremic patients in comparison to healthy controls (3.30 ± 1.32 versus 4.09 ± 1.31 g/2 min; P < 0.02). Nineteen uremic patients (32%) presented with values less than the minimum observed in healthy controls (2.6 g/2 min; Fig 1A). In patients with reduced salivary secretion in whom the test was repeated after 4 months, average results remained unchanged and the test reproducibility VC was satisfactory (VC, 18%).
In hemodialysis patients,
Discussion
The main findings in this study are that salivary and lacrimal function are subnormal in approximately one third of dialysis patients, and impaired salivary function is associated with histological evidence of salivary gland atrophy and fibrosis.
A number of symptoms related to functional impairment of exocrine glands have been described in hemodialysis patients. Alterations of the gastric mucosa with reduced acid secretion associated with amyloid deposition,19 interstitial and periductal
Acknowledgements
The authors thank Pauline Jackson for reviewing the manuscript and Giovanni Tripepi (Epidemiology and Physiopathology of Renal Diseases and Hypertension Section statistical technician) for help given in preparation of the manuscript.
References (27)
- et al.
Oral manifestations and salivary flow rate, pH, and buffer capacity in patients with end-stage renal disease undergoing hemodialysis
Oral Surg Oral Med Oral Pathol Oral Radiol Endod
(1999) - et al.
Clinical and histological skin changes in chronic renal failureEvidence for a dialysis-resistant, transplant-responsive microangiopathy
Lancet
(1980) - et al.
Serum markers of periodontal disease status and inflammation in hemodialysis patients
Am J Kidney Dis
(2002) Hepatitis C-associated autoimmune disorders
Rheum Dis Clin North Am
(1998)- et al.
The causes and consequences of hyposalivation
Ear Nose Throat J
(1988) - et al.
Eye parameters for the diagnosis of xerophthalmos
Clin Exp Rheumatol
(1989) The eye in general medicine, in Oxford Textbook of Medicine (book on CD-ROM)
(1996)Sjögren syndrome, in Oxford Textbook of Medicine (book on CD-ROM)
(1996)- et al.
Studies of parotid saliva and blood in hemodialysis patients
J Appl Physiol
(1967) - et al.
Salivary composition and calculus formation in patients undergoing hemodialysis
J Periodontol
(1980)