Oral and maxillofacial manifestations of chronic kidney disease - mineral and bone disorder: a multicentric retrospective study

Publication date: Available online 10 October 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Flávia Sirotheau Corrêa Pontes, Márcio Ajudarte Lopes, Lucas Lacerda de Souza, Diogo dos Santos da Mata Rezende, Alan Roger Santos-Silva, Jacks Jorge Junior, Wagner Gomes da Silva, Fábio Ramôa Pires, André Caroli Rocha, Wladimir Gushiken de Campos, Milena Coelho Fernandes Caldato, Regina Matsunaga Martin, Felipe Paiva Fonseca, Hélder Antônio Rebelo Pontes
ObjectiveTo describe the oral and maxillofacial manifestations of patients diagnosed with chronic kidney disease - mineral and bone disorders (CKD-MBD).Material and methodsOver a 13-year period, clinicopathological data of patients diagnosed with CKD-MBD who demonstrated oral and maxillofacial alterations were retrieved from the files of four Brazilian institutions. Data included clinical, radiographic, microscopic and biochemical findings, treatment employed and follow-up status.ResultsTwenty-one cases were identified, 13 cases as brown tumor of hyperparathyroidism (BTH) and 8 as osteitis fibrosa/renal osteodystrophy (OF/RO) (4 of them clinically consistent with Sagliker syndrome). The mean age was 32.7 years and the mandible was the most affected site (42.8%). OF/RO showed an ill defined "ground glass" radiographic appearance, and BTH well-defined radiolucent images. Biochemically, the following mean values were obtained: parathyroid hormone 1,511.07pg/ml, Calcium 9.25mg/dl, Phosphorus 5.19mg/dl, Alkaline phosphatase 941.55U/L, Urea 125.42mg/dL and Creatinine 7.14mg/dL. Treatment comprised vitamin D and calcium intake, parathyroidectomy, hemodialysis, renal transplantation and local surgery. During follow-up, 5 BTH patients were free of lesions, whereas 2 affected by OF/RO/Sagliker syndrome died.ConclusionsOral and maxillofacial manifestations of BTH and OF/RO are uncommon, but they can be associated with an important life threatening scenario.



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