Review Article *Corresponding Author: Harshita Gupta, Manav Rachna Dental College, Faridabad, Haryana, India Email: harshitag149@gmail.com IP International Journal of Aesthetic and Health Rejuvenation, July-September, 2019;2(3):48-53 48 Available online at www.iponlinejournal.com Journal homepage: www.innovativepublication.com/journal/ijahr Oral manifestations, dental considerations and treatment protocols for chronic renal disease or end-stage renal disease Harshita Gupta 1* , Sumit Bhateja 2 , Geetika Arora 3 1 Dental Surgeon, 2 HOD, 3 Reader, 2 Dept. of Oral Medicine & Radiology, 3 Dept. of Public Health Dentistry, 1,2 Manav Rachna Dental College, Faridabad, Haryana, 3 Inderprastha Dental College & Hospital, Ghaziabad, Uttar Pradesh, India Abstract 90% of patients suffering from Chronic Renal Disease (CRD) or Chronic Kidney Disease (CKD) show various oral manifestations of the disease. As such, these oral manifestations should be considered as an alarm clock or an early indicator for undiagnosed renal failure. Over the last couple of decades, more and more researchers have noticed the importance of maintaining good oral hygiene in patients with renal disease, especially ESRD patients and transplant candidates. Now, dental protocols have been initiated by them to highlight the psychological aspect of the patient and the importance of maintaining good control of plaque and daily oral hygiene. In this article, we discuss renal disease, its oral manifestations, dental considerations and treatment protocols. Keywords: Renal system, Chronic renal disease, End-Stage renal disease, Dental Considerations, Treatment protocols. Introduction Renal system, also known as Urinary system, or urinary tract, consists of the kidneys, ureters, bladder, and urethra. Its main functions are: 1. Regulate blood volume and composition (e.g. sodium, potassium and calcium) 2. Regulate blood pressure. 3. Regulate pH homeostasis of the blood. 4. Contributes to the production of red blood cells by the kidney. 5. Helps synthesize calcitrol the (active form of Vitamin D). 6. Stores waste product (mainly urea and uric acid) before it and other products are removed from the body. Urologic disease can involve congenital or acquired dysfunction of the urinary system. 1 Chronic kidney disease (CKD) is a type of kidney disease in which a person gradually losses kidney function over a period of months to years. Symptoms may include leg swelling, feeling tired, vomiting, loss of appetite, and confusion. There may be complications like an increased risk of heart disease, high blood pressure, bone disease, and anemia. 2 The most common signs and symptoms of chronic kidney disease include: anemia, blood in urine, dark urine, decreased mental alertness, decreased urine output, edema - swollen feet, hands, and ankles (face if edema is severe), fatigue (tiredness), hypertension (high blood pressure), insomnia, itchy skin, can become persistent, loss of appetite, male inability to get or maintain an erection (erectile dysfunction), more frequent urination, especially at night, muscle cramps, muscle twitches, nausea, pain on the side or mid to lower back, panting (shortness of breath), protein in urine, sudden change in bodyweight, andunexplained headaches. 3 Diseases and conditions that cause chronic kidney disease include: 1. Type 1 or type 2 diabetes 2. High blood pressure 3. Glomerulonephritis, an inflammation of the kidney's filtering units (glomeruli) 4. Interstitial nephritis, an inflammation of the kidney's tubules and surrounding structures 5. Polycystic kidney disease