Dental aspects relating to renal patients

Question 1

What are the main points we must consider when taking a history from a patient with renal failure

Answer 1

1. History of diabetes mellitus
2. Has the patient got CKD?
3. Are there any related bone disorders (renal osteodystrophy)? 4. The possibility of anaemia
4. Questions relating to dialysis: type, frequency, is there an arterio-venous fistula?
5. Has the patient had a transplant? If so: when was the transplant carried out?
6. associated medication including steroids
7. Susceptibility to infection

Question 2

Why do we need to enquire about susceptibility to infection in a patient with renal failure

Answer 2

They have reduced resistance to infection so OH needs to be good to prevent infection occurring

Question 3

What things should we consider in a patietn with renal failure from a dental point of view

Answer 3

1. They are best treated with local analgesia due to anaemia
2. Potential electrolyte disturbances coudl complicate ga
3. Pts often on corticosteroids
4. Pts are often hyptertensive
5. Essential good homeostasis is achieved following oral surgery
6. Pts are best

Question 4

What things should we consider in a patietn with renal failure from a dental point of view

Answer 4

1. They are best treated with local analgesia due to anaemia
2. Potential electrolyte disturbances coudl complicate ga
3. Pts often on corticosteroids
4. Pts are often hyptertensive
5. Essential good homeostasis is achieved following oral surgery
6. Pts are best treated teh day after dialysis as renal function will be optimal

Question 5

When might the kidneys be put under stress

Answer 5

1. Administration of a particular drug
2. Heavy dietary protein load
3. Pregnancy
4. Swallowing large volumes of blood

Question 6

Why drugs are contra indicated in patients who have undergone renal transplant and are taking ciclosporin

Answer 6

Erythromycin as it reduces the metabolism of cyclosporin

Question 7

Which drugs should have their doses reduced in pts with significant kidney disease

Answer 7

1. aciclovir
2. amoxicillin
3. ampicillin,
4. cefalexin
5. erythromycin.
6. Tetracyclines other than doxycyclines should be avoided
7. NSAIDs should not be prescribed