Mayyadah Hameed Rashid
1* 
, Haifaa Abdulameer Radhi
2 , Aseel Abdulameer Radhi
3 1 Department of Dental Techniques, College of Health and Medical Technology, Ashure University, Baghdad, Iraq
2 Department of Dentistry, Alamal College for Specialized Medical Science, Karbala, Iraq
3 Department of Prosthodontics College of Dentistry, University of Karbala, Karbala, Iraq
Abstract
Alterations in oral microbiota can significantly affect systemic health in hemodialysis (HD) patients. Oral dysbiosis contributes to inflammation, production of uremic toxins, and microbial translocation, which can exacerbate cardiovascular disease, chronic kidney disease (CKD), malnutrition, and cognitive impairment. In addition, oxidative stress from periodontal bacteria exacerbates CKD by promoting systemic inflammation, increasing renal oxidative damage, and accelerating functional decline. Conversely, the persistent oxidative stress caused by periodontal bacteria creates a hostile microenvironment in the kidneys, characterized by mitochondrial impairment, membrane damage, disrupted calcium homeostasis, DNA and protein damage, and chronic inflammation. These factors collectively inhibit renal tissue repair mechanisms, accelerating renal failure progression and worsening of kidney outcomes. Managing oral health through good oral hygiene, dietary modifications, and interventions such as probiotics and prebiotics is crucial for improving the overall health and quality of life for HD patients.
Implication for health policy/practice/research/medical education:
Oral dysbiosis is common in hemodialysis (HD) patients, characterized by reduced diversity and increased pathogenic species, contributing to poor oral health and potentially impacting systemic outcomes. In addition, periodontal pathogens significantly contribute to systemic inflammation in chronic kidney disease (CKD) patients by entering the circulation, triggering immune responses, and elevating inflammatory mediators, all of which can worsen renal function and overall health outcomes. Regular dental care and monitoring of oral health are especially important in this population. Factors such as dialysis catheters, dietary restrictions, medications, and oral hygiene practices contribute to these alterations. Modalities like good oral hygiene, probiotics, prebiotics, and dietary modifications can help improve oral microbiota composition in HD patients.
Please cite this paper as: Rashid MH, Radhi HA, Radhi AA. Oral microbiota in hemodialysis patients; a narrative review on recent ideas . J Renal Inj Prev. 2025; x(x): e38685. doi: 10.34172/jrip.2025.38685.