臨牀透析 Vol.35 No.1(8-5)


特集名 透析患者の糖尿病管理の新展開
題名 合併症 (5) (糖尿病合併症としての)歯周病―糖尿病透析患者における歯周病の治療,予防,対策
発刊年月 2019年 01月
著者 稲垣 幸司 愛知学院大学短期大学部歯科衛生学科/愛知学院大学歯学部歯周病学講座
【 要旨 】 歯周炎は,嫌気性細菌感染による慢性の炎症性疾患である.一方,糖尿病は,喫煙とともに歯周病の危険因子であり,腎症,網膜症,神経障害などとともに,歯周病は,糖尿病の慢性合併症として留意する必要がある.さらに歯周病は,死因にまでも関わっていることが示唆されている.しかし,歯周病と慢性腎疾患や透析との関連性を支持する報告は少ない.
透析導入前の慢性腎疾患初期の段階において,すでに歯周病に罹患している可能性が高いため,糖尿病患者は透析に至る前に,早期の歯周病治療や定期的な歯周病管理が必要である.
Theme New perspectives in the management of patients with diabetes undergoing dialysis
Title Periodontal disease (a complication of diabetes): Prevention and treatment of periodontal disease in patients with diabetes undergoing dialysis
Author Koji Inagaki Department of Dental Hygiene, Aichi Gakuin University Junior College / Department of Periodontology, School of Dentistry, Aichi Gakuin University
[ Summary ] Periodontal diseases are infections caused by anaerobic bacteria, which trigger an inflammatory response. Diabetes as a risk factor for periodontal disease and periodontal diseases are associated with several medical conditions including diabetes mellitus and its complications (kidney disease, retinopathy, and/or neuropathy). Periodontal disease is associated with increased mortality in the general population; however, the association between periodontal disease, chronic kidney disease (CKD) and hemodialysis is unknown. It is highly probable that periodontal disease may occur in patients during the early stages of CKD before the initiation of hemodialysis. Therefore, early diagnosis and treatment of periodontal disease and regular periodontal assessment in the period before the initiation of dialysis are important.
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