Evaluation of the correlation between oral infections and systemic complications in kidney transplant patients: a retrospective pilot study.

Dental clearance Kidney transplantation Odontogenic foci Oral bacteria Oral health Systemic complications

Journal

BMC oral health
ISSN: 1472-6831
Titre abrégé: BMC Oral Health
Pays: England
ID NLM: 101088684

Informations de publication

Date de publication:
24 11 2022
Historique:
received: 01 08 2022
accepted: 14 11 2022
entrez: 24 11 2022
pubmed: 25 11 2022
medline: 29 11 2022
Statut: epublish

Résumé

Data regarding the efficacy of the dental clearance required prior to kidney transplantation (KT) for preventing post-transplant complications is controversial. The aim of this retrospective study was to investigate a possible correlation between any untreated oral infectious foci and the onset of systemic complications in KT patients. Patients scheduled for regular check-ups during the post-transplant period were visited at the C.I.R. Dental School in Turin, Italy. Patients were asked to bring orthopantomography (OPT) acquired prior to transplantation to compare the possible presence of untreated infectious foci at the time of transplantation with the time of their post-transplant visit. Patients were then divided, according to the evaluation of the OPT obtained prior to the transplantation, into two groups according to their dental status prior to the transplant. "Group Infected" was comprised of patients with no dental clearance, and "Group Clear" included patients with dental clearance. The medical records were then retrospectively reviewed for the evaluation of any systemic complications that occurred after transplantation. The following medical complications were considered: fever, pneumonia, urinary tract infections, systemic infections, kidney rejection, and death. Complications were divided in two groups: early complications, which occurred within 100 days of transplantation, and late complications, which occurred more than 100 days after transplantation. A total of 77 patients were enrolled in the study. Group Infected was composed of 19 subjects (25%), while Group Clear was composed of 58 patients (75%). In Group Infected, 13 (68%) patients developed complications within 100 days of transplantation, and 11 (58%) did so after 100 days. In Group Clear, 31 (53%) patients had complications within 100 days of the transplant, and 23 (40%) did after 100 days. Patients in Group Infected had a statistically significant increase in episodes of fever (p = 0.03), compared to Group Clear, with a higher relative risk (RR) of 3.66 in the first 100 days after transplantation. Within the limitations of the present retrospective pilot study, and based on the results, a correlation between the absence of dental clearance prior to KT and a higher RR of developing a fever within the first 100 days post transplantation was highlighted. The present results encourage doctors to continue research on the topic, which remains controversial. Further prospective studies are required to confirm the results of the present study.

Sections du résumé

BACKGROUND
Data regarding the efficacy of the dental clearance required prior to kidney transplantation (KT) for preventing post-transplant complications is controversial. The aim of this retrospective study was to investigate a possible correlation between any untreated oral infectious foci and the onset of systemic complications in KT patients.
METHODS
Patients scheduled for regular check-ups during the post-transplant period were visited at the C.I.R. Dental School in Turin, Italy. Patients were asked to bring orthopantomography (OPT) acquired prior to transplantation to compare the possible presence of untreated infectious foci at the time of transplantation with the time of their post-transplant visit. Patients were then divided, according to the evaluation of the OPT obtained prior to the transplantation, into two groups according to their dental status prior to the transplant. "Group Infected" was comprised of patients with no dental clearance, and "Group Clear" included patients with dental clearance. The medical records were then retrospectively reviewed for the evaluation of any systemic complications that occurred after transplantation. The following medical complications were considered: fever, pneumonia, urinary tract infections, systemic infections, kidney rejection, and death. Complications were divided in two groups: early complications, which occurred within 100 days of transplantation, and late complications, which occurred more than 100 days after transplantation.
RESULTS
A total of 77 patients were enrolled in the study. Group Infected was composed of 19 subjects (25%), while Group Clear was composed of 58 patients (75%). In Group Infected, 13 (68%) patients developed complications within 100 days of transplantation, and 11 (58%) did so after 100 days. In Group Clear, 31 (53%) patients had complications within 100 days of the transplant, and 23 (40%) did after 100 days. Patients in Group Infected had a statistically significant increase in episodes of fever (p = 0.03), compared to Group Clear, with a higher relative risk (RR) of 3.66 in the first 100 days after transplantation.
CONCLUSION
Within the limitations of the present retrospective pilot study, and based on the results, a correlation between the absence of dental clearance prior to KT and a higher RR of developing a fever within the first 100 days post transplantation was highlighted. The present results encourage doctors to continue research on the topic, which remains controversial. Further prospective studies are required to confirm the results of the present study.

Identifiants

pubmed: 36424574
doi: 10.1186/s12903-022-02590-8
pii: 10.1186/s12903-022-02590-8
pmc: PMC9685840
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

530

Informations de copyright

© 2022. The Author(s).

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Auteurs

Renato Pol (R)

Department of Surgical Sciences, C.I.R. Dental School, University of Turin, 10126, Turin, Italy.

Davide Camisassa (D)

Department of Surgical Sciences, C.I.R. Dental School, University of Turin, 10126, Turin, Italy.

Marta Bezzi (M)

Department of Surgical Sciences, C.I.R. Dental School, University of Turin, 10126, Turin, Italy.

Luca Savoldi (L)

Department of Surgical Sciences, C.I.R. Dental School, University of Turin, 10126, Turin, Italy.

Federica Punzi (F)

Department of Surgical Sciences, C.I.R. Dental School, University of Turin, 10126, Turin, Italy.

Massimo Carossa (M)

Department of Surgical Sciences, C.I.R. Dental School, University of Turin, 10126, Turin, Italy. massimo.carossa@unito.it.

Tiziana Ruggiero (T)

Department of Surgical Sciences, C.I.R. Dental School, University of Turin, 10126, Turin, Italy.
Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129, Turin, Italy.

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