Salivary changes in chronic kidney disease and in patients undergoing hemodialysis: a systematic review and meta-analysis

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  • Renata Prata Cunha Bernardes Rodrigues, Universidade Federal de Uberlandia
  • ,
  • Maria Tereza Campos Vidigal, Universidade Federal de Uberlandia
  • ,
  • Walbert A. Vieira, Universidade Estadual de Campinas
  • ,
  • Gustavo G. Nascimento
  • Robinson Sabino-Silva, Universidade Federal de Uberlandia
  • ,
  • Cauane Blumenberg, Universidade Federal de Pelotas
  • ,
  • Michelle F. Siqueira, University of Saskatchewan
  • ,
  • Walter L. Siqueira, University of Saskatchewan
  • ,
  • Luiz Renato Paranhos, Universidade Federal de Uberlandia

Objectives: This study is aimed at describing changes in salivary flow rate and ionic composition present in the saliva of chronic kidney disease (CKD) patients by assessing the pH, calcium, phosphate, and phosphorus concentrations and comparing them to healthy individuals, along with exploring the influence of hemodialysis on these parameters. Methods: The bibliographical search was performed in nine databases to find all types of studies, including observational clinical studies, without restrictions regarding publication year or language. Two reviewers selected the studies, extracted the data, and assessed the risk of bias using JBI tools. Random-effect meta-analysis was performed with the standardized mean difference (SMD) as effect estimate, at a 95% confidence interval. Results: Thirty-three studies were included in the qualitative synthesis and 31 studies were included in the meta-analysis. Chronic kidney disease patients presented lower salivary flow rate (SMD: − 1.73; 95% CI = − 2.14; − 1.31), higher pH (SMD: 1.57; 95% CI = 1.11; 2.03), and higher phosphorus concentration (SMD: 0.86; 95% CI = 0.63; 1.09) in saliva. Concurrently, salivary flow rate and pH presented significant changes after hemodialysis, with higher salivary flow rate (SMD: 0.53; 95% CI = 0.25; 0.81) and lower pH (SMD: − 0.53; 95% CI = − 0.88; − 0.19) in patients on hemodialysis treatment. Conclusion: Chronic kidney disease patients present reduced salivary flow rate and increased pH and phosphorus concentration in saliva. Hemodialysis can increase the salivary flow rate of these patients.

Original languageEnglish
JournalJournal of Nephrology
Pages (from-to)1339-1367
Number of pages29
Publication statusPublished - Jun 2022

Bibliographical note

Publisher Copyright:
© 2022, The Author(s) under exclusive licence to Italian Society of Nephrology.

    Research areas

  • Chronic kidney disease, Saliva, Salivary composition, Salivary flow rate

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