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A Comparative Evaluation of Salivary Changes and Oral Indices in Pediatric Patients Having Chronic Kidney Disease and Juvenile Diabetes with Healthy Controls

Shweta Chaudhary, Manasi Rajendra Shimpi, Rajendra Kashinath Shimpi, Laxmi Lakade, Shweta Jajoo, Sneha Desai




Background and Aim: Chronic Kidney disease is a common condition seen in Juvenile diabetes with 90% of renal impairment patients displaying a wide spectrum of oral manifestations in the hard and soft tissues including changes of the salivary composition and flow rate. There is an increase in the serum cystatin-C, urea and creatinine levels in these patients, which is reflected in the saliva. This study was conducted to assess the changes in salivary levels of cystatin-C, urea, and creatinine as well as oral – Decayed, Missing and Filled Teeth Index (DMFT) and gingival indices in pediatric patients suffering from chronic renal disease and juvenile diabetes and compare them with healthy individuals.

Methods: Fifteen patients with juvenile diabetes suffering from chronic renal disease and 15 healthy controls aged 2-18 years were included in the study. Their saliva was analyzed for creatinine, cystatin-C and urea levels using an auto-analyzer and correlated with their existing serum levels. DMFT, gingival index, gingival bleeding and gingival enlargement indices were also assessed.
Results: Increased levels of salivary cystatin C, urea (p value <0.001) and creatinine (p value =0.001) were seen in the cases. The deft value was significantly lower (p value <0.001) while the gingival index, gingival bleeding index, and gingival enlargement index were significantly higher in the subjects with renal impairment. 

Conclusion: Chronic Kidney disease results in many metabolic changes in the body, necessitating frequent biochemical blood analysis. Saliva, being a non-invasive, simple and rapid adjunctive tool, can be used for diagnosing and staging the disease and to check the progression of the condition.

Keywords: Chronic Kidney Disease; Renal Dysfunction; Saliva; Cystatin-C; Diagnosis.


Chronic Kidney Disease; Renal Dysfunction; Saliva; Cystatin-C; Diagnosis.


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DOI: https://doi.org/10.22037/jpn.v7i2.26038


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