Assessment of Oral Manifestation and Inflammatory Markers (IL-17) in End Stage Chronic Kidney Disease Patients: A Cross Sectional Study
DOI:
https://doi.org/10.15218/edj.2026.17Keywords:
Chronic kidney disease, Hemodialysis, Oral manifestations, Interleukin-17, Periodontal disease, XerostomiaAbstract
Background and Objectives: Chronic kidney disease (CKD) is a progressive condition characterized by irreversible deterioration of kidney function, resulting in systemic complications that may adversely affect oral health. Patients undergoing hemodialysis frequently present with various oral manifestations due to metabolic disturbances, medication use, and altered immune responses. Interleukin-17 (IL-17) is an inflammatory cytokine involved in host defense against Candida albicans and may play a role in the oral health status of CKD patients. This study aimed to evaluate oral manifestations and serum IL-17 levels in patients with end stage chronic kidney disease undergoing hemodialysis.
Methods: A cross-sectional study was conducted on 60 participants, including 30 patients with CKD undergoing hemodialysis for more than six months and 30 healthy controls matched for sex. Clinical examinations included assessment of oral dryness, salivary flow rate (sialometry), periodontal status, halitosis, coated tongue, pale oral mucosa, and lip fissures. Serum IL-17 levels were measured using laboratory analysis. Data were analyzed using independent samples t-test and Chi-square test, with statistical significance set at p < 0.05.
Results: Dry mouth, pale oral mucosa, and lip fissures were significantly more prevalent among CKD patients than controls (p < 0.05). Salivary flow rate was significantly reduced, while periodontal disease severity was significantly increased in the CKD group. Although serum IL 17 levels were higher in CKD patients than in healthy controls, the difference was not statistically significant (p = 0.182).
Conclusion: Patients with chronic kidney disease undergoing hemodialysis exhibit a higher prevalence of oral manifestations and periodontal disease compared with healthy individuals. Regular oral healthcare and preventive dental measures are essential for improving oral health outcomes in this population.
References
Glick M. Burket's Oral Medicine. 12th ed. Shelton (CT): People's Medical Publishing House; 2015.
Mohsen IH. Renal failure, types, causes and etiology: a review article. Int J Med Sci Clin Res Stud. 2023;3:1663-1666.
Biga LM, Bronson S, Dawson S, Harwell A. Anatomy and Physiology. Oregon: OpenStax, Oregon State University; 2019.
Supramanian K, et al. Chronic kidney disease: etiology. IntechOpen; 2024.
Kazancioglu R. Risk factors for chronic kidney disease. Kidney Int Suppl. 2013;3(4):368-371.
Rossing P, et al. Risk factors, symptoms, biomarkers, and stages of chronic kidney disease. Diabetes Care. 2021.
Cleveland Clinic. Peritoneal dialysis. Cleveland (OH): Cleveland Clinic; 2024. Available from: https://my.clevelandclinic.org/health/procedures/peritoneal-dialysis
Mehmood Y, Ahmad U. Hemodialysis. Prof Med J. 2019. doi:10.29309/TPMJ/2019.26.01.2511.
Kuravatti S, et al. Oral manifestations of chronic kidney disease: an overview. Int J Contemp Med Res. 2016;3(4).
Hande A, Jaiswal N, et al. Oral manifestations in patients with renal diseases. J Datta Meghe Inst Med Sci Univ. 2020;15(2). doi:10.4103/jdmimsu.jdmimsu_48_19.
Nenova-Nogalcheva A. Oral manifestations consistent with chronic kidney disease. Scripta Sci Med Dent. 2016;2(2). doi:10.14748/ssmd.v2i2.1801.
Ali U, Nadeem A, et al. Oral manifestations of chronic kidney disease. Pak Oral Dent J. 2015;35(3):352-355.
Dioguardi M, Gioia GD, et al. Oral manifestations in chronic uremia patients. Ren Fail. 2016;38(1):1-6. doi:10.3109/0886022X.2015.1103639.
Mayilananthi K, Devi D, et al. Correlating the severity of chronic kidney disease with oral health: a prospective observational study. J Med Sci Clin Res. 2016;4(7):11507-11514. doi:10.18535/jmscr/v4i7.53.
Egbring LC, Lauer T, et al. Xerostomia in dialysis patients: oral care to reduce hyposalivation, dental biofilms and gingivitis in patients with terminal renal insufficiency: a randomized clinical study. Kidney Dial. 2023;3(1):111-120. doi:10.3390/kidneydial3010010.
Mahay P, et al. Oral manifestations of patients with chronic kidney diseases. J Indian Acad Oral Med Radiol. 2024;36(1). doi:10.4103/jiaomr.jiaomr_289_23.
Rohatsch DR. Inflammatory markers explained: understanding blood tests and results. Solv Health. 2024. Available from: https://www.solvhealth.com/
Baciu SF, et al. Chronic kidney disease and periodontitis interplay. Int J Environ Res Public Health. 2023;20(2):1298. doi:10.3390/ijerph20021298.
Trautwein-Weidner K, Gladiator A, LeibundGut-Landmann S. IL-17-mediated antifungal defense in the oral mucosa is independent of neutrophils. Mucosal Immunol. 2015;8(2):221-231. doi:10.1038/mi.2014.57.
ELK Biotechnology. Human IL-17 ELISA Kit (ELK2610). Wuhan, China: ELK Biotechnology; Available from: http://www.elkbiotech.com/
The Jerome L. Greene Sjögren’s Center. Diagnosis of Sjögren’s disease: sialometry. Baltimore (MD): Johns Hopkins University; 2025.
Lasisi TJ, Fasanmade AA, et al. Salivary secretion and composition in malaria: a case-control study. Niger J Physiol Sci. 2015;30(1-2):45-50.
Humphrey SP, Williamson RT. A review of saliva: normal composition, flow, and function. J Prosthet Dent. 2001;85(2):162-169. doi:10.1067/mpr.2001.113778.
Ramfjord SP. The Periodontal Disease Index (PDI). J Periodontol. 1967;38(6):602-610.
Al-Rawi KF, Al-Hamadani AH, et al. Relationship between IL-2, IL-17 concentrations, and serum creatinine levels in men with chronic kidney diseases. Rep Biochem Mol Biol. 2022;10(4):664-671. doi:10.52547/rbmb.10.4.664.
Mengesha BG, Conti HR. The role of IL-17 in protection against mucosal Candida infections. J Fungi (Basel). 2017;3(4):52. doi:10.3390/jof3040052.
Yu IC, Chen CY, Tsai YT, et al. Effects of hemodialysis treatment on saliva flow rate and saliva composition during in-center maintenance dialysis: a cross-sectional study. Ren Fail. 2021;43(1):1-9. doi:10.1080/0886022X.2020.1857769.
Hernández C, et al. Oral disorders in patients with chronic renal failure. J Oral Res. 2016;5(1):27-34. doi:10.17126/joralres.2016.006.
Rafii A, et al. Management of severe periodontitis in hemodialysis patient: a case report. J Dent Forecast. 2021;4(1):1-4.
Hans T, Kumar D, et al. Muco-cutaneous manifestations of chronic kidney disease. Int J Res Dermatol. 2021;7(1):86-90. doi:10.18203/issn.2455-4529.IntJResDermatol20205601.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Aya M. Redha, Hassan A. Barazanji (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The copyright on any article published in Erbil Dental Journal is retained by the author(s) in agreement with the Creative Commons Attribution Non-Commercial ShareAlike License (CC BY-NC-SA 4.0).
