Impact of Dry Mouth and Factors Associated with Sarcopenia on Oral Health-Related Quality of Life in Peritoneal Dialysis Patients.

Abstract

Objectives:  This cross-sectional study aimed to investigate the oral health-related quality of life (OHRQoL), its associated factors, and the prevalence of possible sarcopenia in Thai well-maintained patients with end-stage renal disease (ESRD) undergoing peritoneal dialysis (PD).

Materials and methods:  Data were collected from 63 participants undergoing PD at Banphaeo-Charoenkrung Hemodialysis Center. Dry mouth was evaluated through unstimulated salivary flow rate measurement and self-reported xerostomia questionnaires. OHRQoL was assessed using the Thai version of Oral Health Impact Profile (OHIP-14).

Statistical analysis:  Statistical analyses were conducted using IBM SPSS Statistics version 21.0. Descriptive statistics summarized participant characteristics, and normality was tested with the Kolmogorov-Smirnov test. Continuous variables were expressed as medians and interquartile ranges, while categorical variables were presented as frequencies and percentages. The Mann-Whitney U test and Fisher's exact test were used to assess differences between OHRQoL groups. Partial Spearman's rank correlation examined variable relationships, and logistic regression identified factors linked to a higher negative impact on OHRQoL, adjusting for age, sex, body mass index, chair stand test, and salivary flow rate. A p-value of < 0.05 was considered significant.

Results:  The median age was 59 years (range 27-79), with a possible sarcopenia prevalence of 52.4%. OHIP-14 scores ranged from 0 to 32, with medians of 4 and 13 in a lower (n = 31) and higher (n = 32) negative impact on OHRQoL, respectively. Those with a higher negative impact on OHRQoL exhibited a significantly higher proportion of self-reported xerostomia (p = 0.01), lower salivary flow rate (p = 0.01), and longer 5-time chair stand test (p = 0.04) compared to individuals with the lower negative impact on OHRQoL. Correlation between the time of the chair stand test and the handgrip strength adjusting for age (r = -0.439, p < 0.001) and sex (r = -0.351, p = 0.006) was revealed. Multivariate logistic regression showed a significant association between salivary flow rate and a higher negative impact on OHRQoL (odds ratio 0.018; 95% confidence interval: 0.001, 0.545; p = 0.02).

Conclusion:  This finding suggests that reduced salivary flow affected OHRQoL in well-maintained ESRD patients with PD, highlighting the importance of managing dry mouth to alleviate their OHRQoL.