Clinical Aspects, Oral Health, and Functionality of Patients Undergoing Dialysis in the ICU: A Prospective Study
Intensive Care Units; Acute Kidney Injury; Renal-replacement therapy; Dialysis; Oral Health; Rehabilitation
“Introduction: Critical patients in the ICU requiring dialysis support present high clinical complexity, which can lead to systemic repercussions affecting oral health and mobility. Objective: To evaluate clinical aspects, oral health conditions, and functionality of critical dialysis patients admitted to an ICU, comparing the Acute Kidney Injury (AKI) and Chronic Kidney Disease (CKD) subgroups. Methodology: A prospective observational study was conducted with 68 patients in an ICU in the Federal District, Brazil. Sociodemographic and clinical data were collected, and oral health and functionality were assessed. Results: Sepsis was the main reason for admission, with Hypertension and Diabetes Mellitus as prevalent comorbidities. The incidence of AKI was 55.9%, with conventional intermittent hemodialysis being the most used modality (58.8%). Alcohol consumption stood out as a critical risk factor in the AKI group. Patients with AKI presented higher SAPS 3 scores, longer mechanical ventilation time, prolonged hospital stay, and higher mortality rates compared to the CKD group. Regarding oral health, edentulism was frequent. AKI patients exhibited higher salivary viscosity at admission, with a significant reduction at discharge. Lip dryness was common in both groups, while ulcerated lesions were more expressive in the CKD group. In the functionality analysis, the CKD group showed superior and more homogeneous functional performance, while the AKI group demonstrated greater mobility restriction and functional dependence. There was no significant difference between evolution categories in oral condition and functionality at discharge. Conclusion: Critical dialysis patients present high severity and significant functional and oral impairment. The integration of multidisciplinary care, including dentistry and physical therapy, is essential to reduce morbidity and favor clinical and functional recovery in this population.”