Stimulated Salivary Flow Rate in Chronic Hemodialysis Patients

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Abstract

Background: Reduced salivary flow has been reported in patients undergoing hemodialysis (HD) treatment. Our aim was to investigate the most important factors associated with stimulated salivary flow rate (ssfr) in chronic HD patients. Methods: Fifty HD patients (27 F, 23 M, mean age 46. 7 ± 13.2 years) were divided into two groups according to the duration of HD treatment as those receiving HD therapy less than or equal to (group I) or those more than (group II) 24 months. Fasting blood samples were obtained to determine hepatitis B and C serology, and biochemical and hematological parameters before a HD session. After prestimulation with a standard weight paraffin wax, stimulated saliva was collected in the HD patients and control group (23 F, 25 M, mean age 45.7 ± 19.1 years) and the flow rate was expressed as ml/min. Results: Both HD groups consisted of 25 patients. There was no significant difference between the two HD groups other than serum alkaline phosphatase (ALP) levels and presence of HCV. The ssfr was decreased than controls in both groups (0.8 ± 0.6 and 0.7 ± 0.4, respectively, vs. 1.5 ± 0.5 ml/min) and it did not correlate with any parameter. Smoking had a positive effect on ssfr in all groups. Conclusion: Although the salivary flow rate decreased significantly in chronic HD patients, the duration of therapy displayed no effect on the salivary changes in HD patients, but smoking increased ssfr.

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Impact of smoking cessation on salivary function in healthy volunteers.

Claire Riley, N Trudgill, Gillian L F Smith … (1998)

Salivary bicarbonate and epidermal growth factor (EGF) have an important protective role in the oesophagus. The effect of smoking cessation on these aspects of salivary function is unknown. Salivary bicarbonate secretion and EGF output were measured before and after attempted smoking cessation in 28 healthy volunteers. Urinary cotinine excretion was used to assess compliance. Negative correlations were found between salivary flow rate and age (rho = -0.34) and between cigarette consumption and salivary flow (rho = -0.27) and salivary bicarbonate concentrations (rho = -0.32). Smoking cessation was associated with a significant increase in salivary bicarbonate secretion (day 0, 1.7 (0.14-6.2); day 7, 3.6 (0.52-6.4); day 21, 3.3 (0.44-6.6) micromol min(-1); P < 0.01) but left salivary EGF output unchanged. Smoking cessation is associated with significant improvements in salivary bicarbonate secretion. This would benefit patients with reflux disease who stop smoking.

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Renal osteodystrophy in dialysis patients: diagnosis and treatment.

A. Fournier, R Oprisiu, C Hottelart … (1998)

This article reviews the clinical, biological, radiological, and pathological procedures and their respective indications for the practical diagnosis of the following various histological patterns of renal osteodystrophy: osteitis fibrosa due to parathyroid hormone (PTH) hypersecretion: osteomalacia or rickets due to native vitamin D deficiency and/or aluminum overload; and adynamic bone disease (ABD) due to aluminum overload and/or PTH secretion oversuppression. Our advice regarding bone biopsy is to restrict it to patients with symptoms and hypercalcemia, especially those who have been previously exposed to aluminum. In other cases, we propose relying merely on the determination of the plasma concentrations of calcium, protide, phosphate, bicarbonate, intact PTH, aluminum, 25(OH)D3, and alkaline phosphatase (total and bony if hepatic disease is associated) to choose the appropriate treatment. Because of the danger of the desferrioxamine treatment necessary to chelate and remove aluminum, the suspicion of aluminic bone disease (osteomalacia or ABD) will always be confirmed by a bone biopsy. In the case of nonaluminic osteomalacia, correction of the vitamin D deficiency by native vitamin D or 25(OH)D3, and of the calcium deficiency and acidosis by alkaline salts of calcium and if necessary sodium bicarbonate are sufficient to cure the disease. In the case of nonaluminic ABD, the stimulation of PTH secretion by the discontinuation of 1alpha hydroxylated vitamin D and the induction of a negative calcium balance during dialysis by decreasing the calcium concentration in the dialysate will allow an increase of the CaCO3 dose to correct for hyperphosphatemia without inducing hypercalcemia. For hyperparathyroidism, i.e., plasma intact PTH levels greater than two- or four-fold the upper limit of normal levels (according to the absence or presence of previous aluminum exposure), the treatment will consist in increasing the CaCO3 dose to correct for hyperphosphatemia together with a decrease of the calcium concentration in the dialysate if the dose of CaCO3 is so high that it induces hypercalcemia. When the hyperphosphatemia has been corrected and there is still a low or normal corrected plasma calcium level, 1alpha(OH)D3 in an oral bolus 2 or 3 times a week should be given at the minimal dose of 1 microg. When the PTH level stays above 400 pg while hypercalcemia occurs and hyperphosphatemia persists, surgical subtotal parathyroidectomy is recommended or the injection of calcitriol into the big nodular hyperplastic parathyroid glands under sonography control in high surgical risk patients. Special recommendations are given for children.

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The effect of repeated sampling on paraffin-stimulated salivary flow rates in menopausal women

M. Laine, K Pienihäkkinen, R Leimola-Virtanen (1999)

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Author and article information

Journal

Journal ID (publisher-id): NEF

Journal ID (nlm-ta): Nephron

Journal ID (doi): 10.1159/issn.1660-8151

Title: Nephron

Publisher: S. Karger AG

ISSN (Print): 1660-8151

ISSN (Electronic): 2235-3186

Publication date Subscription-year: 2002

Publication date (Print): June 2002

Publication date (Electronic): 03 June 2002

Volume: 91

Issue: 2

Pages: 210-214

Affiliations

School of Dental Medicine, Department of Prosthetic Dentistry and School of Medicine, Department of Internal Medicine, Division of Nephrology, University of Istanbul, Turkey

Article

Publisher ID: 58394 Other ID: Nephron 2002;91:210–214

DOI: 10.1159/000058394

PubMed ID: 12053055

SO-VID: eccda487-4929-4f97-918e-2ce791e9dea0

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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

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Stimulated Salivary Flow Rate in Chronic Hemodialysis Patients

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Abstract

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Karger: Nephrology

Most cited references 3

Impact of smoking cessation on salivary function in healthy volunteers.

Renal osteodystrophy in dialysis patients: diagnosis and treatment.

The effect of repeated sampling on paraffin-stimulated salivary flow rates in menopausal women

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