FlashcardsMedical conditions: Endocrine, GI & renal

Chronic kidney disease and ESRD flashcards

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How does Chronic kidney disease and ESRD affect dental management?

1 / 7

How does Chronic kidney disease and ESRD affect dental management?

Nephrology review: current kidney function, anemia and bleeding history, relevant laboratory results, dialysis and anticoagulation schedule, and transplant/immunosuppression plan
Procedural prophylaxis: AAPD lists hemodialysis and solid-organ transplantation for individualized physician consultation about prophylaxis. A fistula or vascular graft alone is not an IE-prophylaxis indication. AAPD 2026 and compromised immunity.
Fistula protection: Don't take blood pressure or place an IV on the fistula arm
Medication review: avoid NSAIDs; check each antibiotic’s renal precautions and dose-adjust renally cleared agents such as penicillins and acyclovir.
Before transplant: prioritize infection, nonrestorable teeth, and likely sources of pain during immunosuppression.
Choose tooth treatment: restoration, pulp treatment, or extraction based on diagnosis/prognosis and available follow-up; agree on healing time with the transplant team.
Fluoride: Coordinate systemic fluoride supplementation with nephrology because renal clearance is reduced; maintain topical prevention

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Treatment phase	Dental priority
Hemodialysis	Coordinate a nondialysis day with anticoagulation and clinical status; protect the fistula arm.
Before transplant	Treat infection and poor-prognosis disease with team-agreed healing time.
After transplant	Review actual immunosuppression, immune recovery, gingival effects, and adrenal risk.
All phases	Check renal drug dosing and bleeding risk; maintain topical prevention.