Qualidade de vida relacionada à saúde bucal e depressão em pacientes com doença renal crônica submetidos à hemodiálise

• Autor(a) principal: Norte, Antônia Edênia Oliveira
• Data de Publicação: 2017
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da Universidade Federal do Ceará (UFC)
• Texto Completo: http://www.repositorio.ufc.br/handle/riufc/40531
• topic: Saúde bucal; Insuficiência renal crônica; Diálise renal

Patients with chronic kidney disease (CKD) undergoing hemodialysis have a high prevalence of depressive symptoms and an increased risk of tooth and gum disease. The main objective of this study was to verify the association between quality of life related to oral health and depression in patients with chronic kidney disease undergoing hemodialysis. We studied 177 patients with chronic kidney disease over 18 years of age and with at least three months undergoing hemodialysis treatment. All patients in the sample were treated in the two dialysis units that are a reference for the treatment of CKD in the northwestern region of the state of Ceará. Demographic, clinical and laboratory data were collected, as well as questionnaires about the habits of oral hygiene practiced as well as about the use of dental services by patients. The assessment of the quality of life related to oral health was performed by applying the OHIP instrument that encompasses seven dimensions of quality of life: functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability and social disadvantage. OHIP generates scores from 0 to 56 and the higher the score the worse the quality of life. The screening of depressive symptoms was performed by the instrument CES-D that generates scores from 0 to 60. Score equal to or greater than 18 classifies the individual as depressive. The sample consisted of a majority of men (62.0%), with a mean age of 49 years and a higher concentration in social classes C and D (87.5%). The majority (92.1%) performed at least one dental visit, and the consultation was conducted in the last 12 months for 57% of subjects. Almost half (45%) used dental prostheses and 42.4% never received any guidance about oral health from the health professionals involved in their care. The prevalence of depression in the sample was 24.9%. The association between quality of life related to oral health was demonstrated by the positive correlation between the OHIP and CES-D scores (r = 0.450; p <0.001), as well as by the higher score in depressed patients when compared to non-depressed patients depressed (18.5 versus 9.0, p <0.001). In the multivariate analysis the male sex was protective for the presence of depression (OR = 0.340, CI = 0.142-0.811), while high scores generated by OHIP (low quality of life related to oral health) increased by 13% the risk for depression (OR = 1.134, CI = 1.079-1.235). Strategies should be drawn and carried out by the health teams involved in the care of patients with CKD to improve the oral health of patients aiming for better well-being and lower risk of depressive symptoms.