The oral cavity as a diagnostic interface in kidney disease: clinical markers and pathophysiological correlates – a systematic review.

Introduction. Chronic kidney disease (CKD) is not just an isolated renal disorder, but also a complex systemic condition with consequences that extend far beyond renal function alone. Among these, oral changes have become increasingly relevant because the oral cavity may reflect inflammatory, metabolic, microbiological and immunological alterations associated with kidney disease. Aim of the study. The aim of this systematic review was to evaluate the oral status of patients with chronic kidney disease by analyzing the main oral clinical manifestations and the principal
pathophysiological mechanisms linking oral findings with CKD. Methods. A systematic review with narrative synthesis was performed to assess oral manifestations, salivary changes, periodontal involvement, oral microbiological findings, tongue-related features and salivary biomarkers in patients with chronic kidney disease. Results. The reviewed evidence consistently showed that patients with CKD present xerostomia, oral mucosal changes, taste disturbances, burning mouth sensation, gingival inflammation, periodontal disease, increased calculus accumulation, and salivary abnormalities. Several studies also suggested that saliva, periodontal status, and specific tongue-related findings may provide useful non-invasive information about kidney disease and, in some particular cases, about its severity. Conclusions. The oral cavity may be considered as a valuable clinical and biological interface in kidney disease. Careful oral examination, together with salivary and periodontal evaluation, may contribute to earlier recognition of systemic deterioration and support a more integrated, interdisciplinary approach to patients with CKD.

DOI: https://doi.org/10.62838/ASMJ.2026.1.05