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Results
Distribution of the Subjects
One hundred and eighty subjects participated in the study, 108 (60%) males and 72 (40%) females. Average age of the subjects was 47.73 ± 16.08 years and majorities (96.7%) of the subjects were of Yoruba ethnicity (Table 1).
Oral Soft Tissue Lesion. Abnormal lip pigmentation was the most frequent lesion seen in CKD subjects, seen 81 out of 90 CKD subjects (90%). Other significant lesions seen include candidiasis, pale mucosa, petechial hemorrhage and periodontitis (Table 2).
Glomerular Filtration Rate and Presence of Oral Lesions. A positive relationship was found between the estimated GFR and oral lesions in cases and in controls, and this was statistically significant as shown in the Table 3.
Mean GFR and Oral Lesions in CKD Subjects. In this study, aphthous ulcers were seen in CKD subjects with high mean GFR(57.6 ml/min per 1.73 m surface area) unlike oral candidiasis which was seen in subjects with low mean GFR( 35.5 ml/min per 1.73 m surface area). Other lesions seen at a significantly lower mean GFR are: xerostomia, halitosis and abnormal lip pigmentation seen in subjects with mean GFR of 38.6 ml/min per 1.73 m surface area, 39.7 ml/min per 1.73 m surface area and 49.7 ml/min per 1.73 m surface area respectively.
Relationship Between Oral Lesions and Blood Urea Concentration in Renal Patients. The mean blood urea concentration in CKD patients with oral lesions (9.4 mmol/L) was higher compared with those without oral lesions (5.1 mmol/L) although the difference was not statistically significant P = 0.08. Blood urea nitrogen was highest in patients with oral candidiasis (12.5 mm/L) followed by those with halitosis (12.1 mmol/L), xerostomia (11.6 mmol/L), pale mucosa (11.1 mmol/L) and periodontitis (9.4 mmol/L).
Regression Analysis
Table 4 shows the association between chronic kidney disease and development of oral lesions after adjusting for age and sex. The likelihood of developing oral lesions was significantly higher in subjects with CKD compared with controls (Odds ratio 153.3, 95% C.I (40.1–584.8), p < 0.001). Age and sex did not have a significant relationship with the likelihood of developing oral lesion.
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