Effectiveness of nutritional support team interventions in improving the nutritional status of in-hospital dental patients with decreased renal function.

Introduction

chronic kidney disease (CKD) is a major risk factor for end-stage renal disease, and owing to its increasing global prevalence, poses a serious public health challenge. Patients with CKD frequently experience protein-energy wasting, frailty, sarcopenia, and cachexia, necessitating complex dietary restrictions, including protein, salt, and potassium limitation. Although a nutrition support team (NST) can improve nutritional status in hospitalised patients, additional interventions such as swallowing evaluation, oral care, and medication adjustments are crucial for effective outcomes. CKD is also strongly correlated with periodontal disease and diabetes: tooth loss and oral frailty exacerbate low nutritional intake, especially in older individuals.

Objectives

to examine whether NST intervention combined with dental care would enhance nutritional and oral parameters in hospitalised patients referred for dental treatment.

Methods

twenty-seven patients were assigned to either an NST-intervention (n = 10) or non-NST (n = 17) groups. We assessed serum albumin, C-reactive protein (CRP), body mass index (BMI), Subjective Global Assessment scores, remaining teeth, periodontal pocket depth, and bleeding on probing.

Results

over a 1-month period, both groups showed significant decline in body weight and BMI, whereas albumin, CRP, and periodontal indices did not substantially change. The NST group demonstrated a higher proportion (50 %) of improved carbohydrate intake than the non-NST group (11 %), but this difference was not statistically significant. Reduced appetite was correlated with meal reduction, decreased body weight and meal reduction, and swallowing difficulties.

Conclusions

short-term periodontal or NST interventions are insufficient for achieving significant improvements in CKD-associated malnutrition or periodontal status; therefore, more specialised interventions are needed.