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2013, Number 6

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Rev ADM 2013; 70 (6)

Candida species in oral candidiasis in diabetic patients with and without chronic renal failure

de la Rosa-García E, Miramontes-Zapata M, Bustos J, Mondragón-Padilla A

Language: Spanish
References: 30
Page: 302-308
PDF size: 354.39 Kb.


ABSTRACT

Introduction: Oral candidiasis is a common opportunistic infection in chronic kidney disease patients. The aim of this study is to assess the prevalence of oral candidiasis and the species of Candida that cause it in a group of diabetic CKD (CKD-DM) patients and non-CKD (DM) patients, and to evaluate possible risk factors. Methods: 56 CKD-DM and 118 DM patients were recruited for the study. Demographic, clinical and oral variables were analyzed, including oral prostheses, xerostomy, and salivary flow. Oral candidiasis was confirmed by means of a cytological smear and cultured on Sabouraud dextrose agar. Species identification was achieved using BioMérieux API 20C AUX. Statistical analysis was performed using the Student’s t-test, the χ2 test, and Fisher’s exact test, as well as multiple logistic regression. Results: The prevalence of oral candidiasis in CKD-DM patients was 23.2% versus 16% in DM patients, p = 0.258. The duration of diabetes was longer in the CKD-DM patients, p ‹ 0.001. Prosthesis-associated oral candidiasis was 61.5% in the CKD-DM patients (OR = 10.9, p = 0.003); hyposalivation (p = 0.044) and xerostomia (p = 0.048) were greater in the CKD-DM patients. Candida albicans was the causal species of oral candidiasis in 50% of the CKD-DM patients and in 95% of the DM patients (p = 0.002). Non-albicans Candida tended to be associated with CKD-DM patients undergoing hemodialysis (OR = 38.3, p = 0.058). Conclusions: The greater prevalence of non-albicans Candida in CKD-DM patients is consistent with reports that non-albicans Candida is more common in patients with more long-standing illnesses, whilst a greater prevalence of oral candidiasis in CKD-DM patients with oral prostheses suggests poor prosthesis care.


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