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SALIVA COMPOSITION AND UPPER GASTROINTESTINAL SYMPTOMS IN CHRONIC KIDNEY DISEASE
Author(s) -
Manley Karen Joy
Publication year - 2014
Publication title -
journal of renal care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.381
H-Index - 27
eISSN - 1755-6686
pISSN - 1755-6678
DOI - 10.1111/jorc.12062
Subject(s) - saliva , medicine , dry mouth , retching , nausea , gastroenterology , sodium bicarbonate , chemistry
SUMMARY Objective To investigate self‐reported upper gastric symptoms experienced by patients with chronic kidney disease (CKD) and compare associations between uraemic symptoms and saliva composition. Methods In a cross‐sectional observational study, 30 patients with Stages 4 and 5 CKD were selected from a tertiary hospital renal outpatient clinic. Subjects answered a questionnaire to assess upper gastrointestinal (GI) symptoms. A saliva sample was collected to determine biochemical composition. Possible associations between saliva composition and uraemic upper GI symptoms were assessed. Results Only 3 (10%) patients reported no upper GI symptoms whilst 19 (63%) complained of a dry mouth, 16 (56%) had a change in taste, 9 (30%) had nausea, 7 (23%) vomited and 7 (23%) dry retched. Lower saliva bicarbonate concentration related to both dry mouth (p < 0.003) and dry retching (p < 0.01). An elevated level of saliva calcium was also implicated in a dry mouth sensation (p < 0.01). Nausea was associated with higher saliva sodium levels (p < 0.03) and a higher saliva sodium/potassium ratio (p < 0.02). Conclusion Altered saliva composition in patients with Stages 4 and 5 CKD may be associated with uraemic upper GI symptoms. In particular, lower saliva concentrations of bicarbonate are associated with dry mouth and retching. Higher saliva calcium levels are also related to a dry mouth whilst higher saliva sodium levels and a greater sodium/potassium ratio are associated with nausea. Further studies investigating strategies to improve uraemic symptoms via changes in saliva are required.

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