Oral health care among dialysis patients in France and impact on survival.

Abstract

Background: Oral diseases have been shown to be risk factors of Chronic Kidney Disease (CKD) progression and may also be associated with poorer survival. The aim of this study was to describe oral care of dialysis patients in France and to assess its impact on their survival.

Methods: We conducted a retrospective cohort study including all patients on dialysis in France between 2015 and 2020. Data were collected from the French REIN registry and matched with the National Health Data System. Factors associated with the probability of receiving oral care treatments were explored using a logistic regression model. The survival of incident dialysis patients was modeled using a Cox model.

Results: Among the 101,942 prevalent patients included in our sample, 32.5% received oral care treatment over the 6-year study period. Average annual adoption was 18.7% (versus 43% in the general French population) with regional variations. Male gender, overweight, dialysis treatment < 3 and > 6 years, and being on the transplant waiting list were associated with greater oral care treatment. Oral care treatment was associated with a lower risk of death (weighted hazard ratio (HR) 0.53 [0.51-0.55], adjusted HR 0.50 [0.48-0.52] 95% confidence interval (CI)).

Conclusion: Dialysis patients in France undergo a low level of oral care treatments. Patients' characteristics and regional practices appear to influence this. Oral care treatments seem to have a positive impact on survival.