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Biochemical study of whole saliva from children with chronic renal failure
F Obry1, A B Belcourt, R M Frank
1Centre de Recherches Odontologiques, Unité Inserm U 157, Faculté de Chirurgie Dentaire, Strasbourg, France.
Insights
Children with chronic renal failure exhibit altered salivary composition, with significantly reduced urea and depleted calcium and magnesium levels post-dialysis. These biochemical changes correlate with very low caries activity in these patients.
Area of Science:
- Biochemistry
- Pediatric Nephrology
- Oral Health
Background:
- Children with chronic renal failure (CRF) often present with unique oral health profiles.
- Low caries activity has been anecdotally observed in CRF patients, suggesting a potential link to salivary composition.
Purpose of the Study:
- To investigate the biochemical composition of unstimulated whole saliva in children with CRF.
- To assess the impact of dialysis on salivary components.
- To correlate salivary findings with caries activity and blood parameters.
Main Methods:
- Analysis of unstimulated whole saliva and blood samples from ten children with CRF before (T) and after (To) dialysis.
- Comparison with a healthy control group.
- Quantification of salivary urea, free amino acids, and electrolytes (calcium, magnesium).
Main Results:
- Salivary urea concentration was significantly higher in CRF patients (513 mg/100 ml pre-dialysis, 241 mg/100 ml post-dialysis) compared to controls (110 mg/100 ml).
- Dialysis effectively reduced salivary urea, though levels remained elevated post-treatment.
- Increased concentrations of basic free amino acids were observed post-dialysis. Blood calcium and magnesium levels were notably depleted in CRF patients compared to controls and pre-dialysis values.
Conclusions:
- Children with CRF exhibit distinct salivary biochemical alterations, including elevated urea and changes in amino acid profiles.
- Dialysis partially normalizes salivary urea but does not fully restore it to control levels.
- Salivary depletion of calcium and magnesium may contribute to the observed low caries activity in this population.
Abstract:
The biochemical composition of unstimulated whole saliva was studied on ten children suffering from chronic renal failure and who, at the same time, displayed a very low caries activity. Various salivary components were studied before (T) and after (To) dialysis and were compared with similar elements of a control group, as well as with blood values. A mean salivary urea concentration of 513 +/- 210 mg/100 ml was found prior to dialysis, whereas after treatment this value dropped to 241 +/- 82 mg/100 ml, about twice as much as in the control group, 110 +/- 48 mg/100 ml. The mean urea concentrations in blood at T and To were respectively 196 +/- 38 mg/100 ml and 53 +/- 22 mg/100 ml. The various free amino acids in the whole saliva of these patients showed different changes in their concentrations as a result of dialysis, with the basic amino acids being considerably increased. Blood electrolytes remained close to the normal range, although calcium was depleted and magnesium lowered by a factor of 10 when compared before and after dialysis, as well as versus the control group.