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Abstract: TH-PO300

Dental Care Decreased the Risk of Not Only Cardiovascular Events but Peritonitis for the Patients on Peritoneal Dialysis

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Hiramatsu, Takeyuki, Konan Kosei Hospital, Konan Aichi, Japan
  • Asano, Yuko, Konan Kosei Hospital, Konan Aichi, Japan
  • Suzuki, Katsuhiko, Konan Kosei Hospital, Konan Aichi, Japan
  • Iguchi, Daiki, Konan Kosei Hospital, Konan Aichi, Japan
  • Furuta, Shinji, Konan Kosei Hospital, Konan Aichi, Japan
Background

Oral disease may be increased in people with end stage renal disease (ESRD) and associated with inflammation, cardiovascular disease and mortality. We had the patient who had severe gingivitis and suffered from sepsis due to oral Streptococcus Salivarius, and followed splenic abscess and peritonitis on January 2010. Hence we noticed the importance of dental care, and after Jan. 2010, we have been recommended to patients on peritoneal dialysis to have dental care, including 3 and more times tooth brushing, oral hygiene, more frequent dental visit and prophylactic antibiotics treatment before scaling or caries treatment.

Methods

We evaluated the difference of the incidence between two groups; peritoneal dialysis (PD) treatment from January 2000 to December 2009 (Group A), and January 2010 to May 2019 (Group B). We compared the admission rate of peritonitis, especially Streptococcus peritonitis, congestive heart failure (HF), acute coronary syndrome (ACS), cerebrovascular disease (CVD), and pneumonia. And the causes of death were also evaluated.

Results

The cumulative annual peritoneal dialysis patients in group A and B were 342 and 65 (mean age ; 61.8 vs 65.9 years : p < 0.01) respectively, and PD treatment were 3404 vs 6219month・person(p < 0.01). According to the cause of disease, diabetes was same , but glomerulonephritis was decreased, and nephrosclerosis was increased after 2010. The incidence of peritonitis (0.275 vs 0.179/person・year:p < 0.001), Streptococcal peritonitis (0.081 vs 0.046/person・year : p < 0.05), HF (0.159 vs 0.089/person・year: p < 0.005), ACS (0.109 vs 0.025/person・year: p < 0.001), CVD (0.060 vs 0.029/person・year: p < 0.05) , Pneumonia (0.078 vs 0.041/person・year:p < 0.05) were lower in group B than in group A. Moreover, according to the cause of death, the data were the same fashion as above.

Conclusion

Dental care was beneficial for not only CVD, but also peritonitis, especially Staphylococcal peritonitis. Considering, peritonitis and CVD may provide poor QOL and mortality, dental care (3 and more times tooth brushing, oral hygiene, more frequent dental visit and prophylactic antibiotics treatment before scaling or caries treatment) is important for better QOL and treatment survival and mortality.