Journals / Nefroloji Hemşireliği Dergisi / 2026 / Cilt: 21 Sayı: 3

Assessment of Xerostomia Levels in Patients Undergoing Hemodialysis Treatment/Hemodiyaliz Tedavisi Gören Hastalarda Kserostomi Düzeyinin Değerlendirilmesi

Hemodiyaliz Tedavisi Gören Hastalarda Kserostomi Düzeyinin Değerlendirilmesi/Assessment of Xerostomia Levels in Patients Undergoing Hemodialysis Treatment

Pages
153–164
Publication Date
2026-09-30
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Therefore, integrating the assessment of subjective symptoms with objective findings into routine nursing assessment may facilitate the early identification of individual needs and support the planning of targeted, individualised supportive care for patients undergoing haemodialysis

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Aim: The aim of this study was to evaluate xerostomia in patients undergoing haemodialysis from a nephrology nursing perspective and to examine the association between subjective xerostomia symptoms and objective indicators of oral dryness.
📊
Key Findings & Data:Materials and Methods: This descriptive, cross-sectional study included 40 patients undergoing haemodialysis at the Haemodialysis Unit of Sabuncuoğlu Şerefeddin Training and Research Hospital.
💡
Conclusion & Impact:Therefore, integrating the assessment of subjective symptoms with objective findings into routine nursing assessment may facilitate the early identification of individual needs and support the planning of targeted, individualised supportive care for patients undergoing haemodialysis
🔬Design:Araştırma Makalesi
📍Scope:Comprehensive Sample
⚙️Variables:Ağız Sağlığı · Ağız Kuruluğu · Hemodiyaliz

Abstract

Aim: The aim of this study was to evaluate xerostomia in patients undergoing haemodialysis from a nephrology nursing perspective and to examine the association between subjective xerostomia symptoms and objective indicators of oral dryness. Materials and Methods: This descriptive, cross-sectional study included 40 patients undergoing haemodialysis at the Haemodialysis Unit of Sabuncuoğlu Şerefeddin Training and Research Hospital. Data were collected through face-to-face interviews using a Personal Information Form and the 11-item Subjective Oral Dryness Assessment Form. Salivary pH was assessed using a pH indicator, while objective oral dryness was evaluated using the Modified Schirmer Test. Salivary flow rate was not directly measured. Results: The mean xerostomia symptom score was 24.05±12.60 (possible score range: 0-110), with thirst being the most frequently reported symptom. No statistically significant difference was observed between pre- and post-haemodialysis objective oral dryness scores. Salivary pH values were within the physiological range. No statistically significant associations were found between xerostomia symptom scores and demographic characteristics, medication use, salivary pH, or clinical oral health indicators. Furthermore, no significant correlation was identified between xerostomia symptom scores and objective oral dryness measurements obtained using the Modified Schirmer Test. Conclusion: The absence of a significant correlation between xerostomia symptoms and objective oral dryness assessed using the Modified Schirmer Test suggests that subjective and objective indicators of oral dryness may not always correspond. Therefore, integrating the assessment of subjective symptoms with objective findings into routine nursing assessment may facilitate the early identification of individual needs and support the planning of targeted, individualised supportive care for patients undergoing haemodialysis

Özet

Amaç: Bu çalışmanın amacı, hemodiyaliz hastalarında kserostomiyi nefroloji hemşireliği bakış açısıyla değerlendirmek ve subjektif kserostomi semptomları ile objektif oral kuruluk göstergeleri arasındaki ilişkiyi incelemektir. Gereç ve Yöntem: Tanımlayıcı ve kesitsel nitelikteki bu çalışmanın örneklemini, Sabuncuoğlu Şerefeddin Eğitim ve Araştırma Hastanesi Hemodiyaliz Biriminde tedavi gören 40 hemodiyaliz hastası oluşturmuştur. Veriler, yüz yüze görüşme yöntemiyle “Kişisel Bilgi Formu” ve 11 maddeden oluşan “Ağız Kuruluğu Subjektif Değerlendirme Formu” kullanılarak toplanmıştır. Tükürük pH'sı, pH indikatörü ile, objektif oral kuruluk ise Modifiye Schirmer Testi kullanılarak değerlendirilmiştir. Tükürük akış hızı doğrudan ölçülmemiştir. Bulgular: Kserostomi semptom skoru 24,05±12,60 (olası puan aralığı: 0-110) olarak bulunmuş ve en sık bildirilen yakınma susuzluk olmuştur. Hemodiyaliz öncesi ve sonrası objektif oral kuruluk skorları arasında anlamlı bir fark saptanmamıştır. Tükürük pH değerlerinin fizyolojik sınırlar içinde olduğu belirlenmiştir. Kserostomi semptom skorları ile demografik özellikler, ilaç kullanımı, tükürük pH ve klinik ağız sağlığı göstergeleri arasında anlamlı bir ilişki bulunmamıştır. Kserostomi semptom skorları ile Modifiye Schirmer Testi kullanılarak değerlendirilen objektif oral kuruluk ölçümleri arasında anlamlı bir korelasyon saptanmamıştır. Sonuç: Kserostomi semptomları ile Modifiye Schirmer Testi ile değerlendirilen objektif oral kuruluk göstergeleri arasında anlamlı korelasyon saptanmaması, bu göstergelerin her zaman paralellik göstermeyebileceğini düşündürmektedir. Bu nedenle hemodiyaliz hastalarında ağız kuruluğunun değerlendirilmesinde subjektif semptomların objektif bulgularla birlikte ele alınması ve rutin hemşirelik değerlendirmesine entegre edilmesi, bireysel gereksinimlerin erken belirlenmesini ve hedefe yönelik destekleyici bakımın planlanmasını sağlayabilir.

🔖

Cite This Article

Ilıman, A. Y., Erten, A., *, A. Y. I. (2026). Assessment of Xerostomia Levels in Patients Undergoing Hemodialysis Treatment/Hemodiyaliz Tedavisi Gören Hastalarda Kserostomi Düzeyinin Değerlendirilmesi. Nefroloji Hemşireliği Dergisi, Cilt: 21 Sayı: 3, 153–164. https://doi.org/10.47565/ndthdt.2026.133

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (39)

  1. Levin A, Stevens PE, Bilous RW, Coresh J, De Francisco ALM, De Jong PE, et al. Kidney disease: improving global outcomes (KDIGO) CKD work group. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl. 2013;3(1):1-150. https://doi.org/10.1038/kisup.2012.73
  2. Mills KT, Xu Y, Zhang W, Bundy JD, Chen CS, Kelly TN, et al. A systematic analysis of worldwide population-based data on the global burden of chronic kidney disease in 2010. Kidney Int. 2015;88(5):950-7. https://doi.org/10.1038/ki.2015.230
  3. Thurlow JS, Joshi M, Yan G, Norris KC, Agodoa LY, Yuan CM, et al. Global epidemiology of end-stage kidney disease and disparities in kidney replacement therapy. Am J Nephrol. 2021;52(2):98-107. https://doi.org/10.1159/000514550
  4. Davison SN, Jhangri GS. Impact of pain and symptom burden on the health-related quality of life of hemodialysis patients. J Pain Symptom Manage. 2010;39(3):477-85. https://doi.org/10.1016/j.jpainsymman.2009.08.008
  5. Bossola M, Tazza L. Xerostomia in patients on chronic hemodialysis. Nat Rev Nephrol. 2012;8(3):176-82. https://doi.org/10.1038/nrneph.2011.218
  6. Rodrigues RPCB, Vidigal MTC, Vieira WA, Nascimento GG, Sabino-Silva R, Blumenberg C, et al. Salivary changes in chronic kidney disease and in patients undergoing hemodialysis: a systematic review and meta-analysis. J Nephrol. 2022;35(5):1339-67. https://doi.org/10.1007/s40620-022-01274-4
  7. Bossola M. Xerostomia in patients on chronic hemodialysis: an update. Semin Dial. 2019. https://doi.org/10.1111/sdi.12821
  8. Zemedikun DT, Chandan JS, Raindi D, Rajgor AD, Gokhale KM, Thomas T, et al. Burden of chronic diseases associated with periodontal diseases: a retrospective cohort study using UK primary care data. BMJ Open. 2021;11(12). https://doi.org/10.1136/bmjopen-2020-048296
  9. Kumar NN, Panchaksharappa MG, Annigeri RG. Modified Schirmer test-a screening tool for xerostomia among subjects on antidepressants. Arch Oral Biol. 2014;59(8):829-34. https://doi.org/10.1016/j.archoralbio.2014.05.008
  10. Duruk N, Eser I. The null effect of chewing gum during hemodialysis on dry mouth. Clin Nurse Spec. 2016;30(5). https://doi.org/10.1097/NUR.0000000000000234
  11. Camacho-Alonso F, Cánovas-García C, Martínez-Ortiz C, De la Mano-Espinosa T, Ortuño-Celdrán T, Marcello-Godino J, et al. Oral status, quality of life, and anxiety and depression in hemodialysis patients and the effect of the duration of treatment by dialysis on these variables. Odontology. 2018;106(2):194-201. https://doi.org/10.1007/s10266-017-0313-6
  12. Kaushik A, Reddy S, Umesh L, Devi B, Santana N, Rakesh N. Oral and salivary changes among renal patients undergoing hemodialysis: a cross-sectional study. Indian J Nephrol. 2013;23(2):125-9. https://doi.org/10.4103/0971-4065.109421
  13. López-Pintor RM, López-Pintor L, Casañas E, de Arriba L, Hernández G. Risk factors associated with xerostomia in haemodialysis patients. Med Oral Patol Oral Cir Bucal. 2017;22(2). https://doi.org/10.4317/medoral.21612
  14. Bots CP, Brand HS, Veerman ECI, Valentijn-Benz M, Van Amerongen BM, Valentijn RM, et al. Interdialytic weight gain in patients on hemodialysis is associated with dry mouth and thirst. Kidney Int. 2004;66(4):1662-8. https://doi.org/10.1111/j.1523-1755.2004.00933.x
  15. Honarmand M, Farhad-Mollashahi L, Nakhaee A, Sargolzaie F. Oral manifestation and salivary changes in renal patients undergoing hemodialysis. J Clin Exp Dent. 2017;9(2). https://doi.org/10.4317/jced.53215
  16. Patil S, Khaandelwal S, Doni B, Rahuman F, Kaswan S. Oral manifestations in chronic renal failure patients attending two hospitals in North Karnataka, India. Oral Health Dent Manag [Internet]. 2012 [cited 2025 Dec 29];11(3):100-6. Available from: https://pubmed.ncbi.nlm.nih.gov/22976569/
  17. Fan WF, Zhang Q, Luo LH, Niu JY, Gu Y. Study on the clinical significance and related factors of thirst and xerostomia in maintenance hemodialysis patients. Kidney Blood Press Res. 2013;37(4-5):464-74. https://doi.org/10.1159/000355717
  18. Kamath G, Devananda D. Prevalence of xerostomia in patients on haemodialysis: a systematic review and meta-analysis. Gerodontology. 2021;38(3):235-41. https://doi.org/10.1111/ger.12526
  19. Yu IC, Liu CY, Fang JT. Effects of hemodialysis treatment on saliva flow rate and saliva composition during in-center maintenance dialysis: a cross-sectional study. Ren Fail. 2021;43(1):71-8. https://doi.org/10.1080/0886022X.2020.1857769
  20. Xu F, Laguna L, Sarkar A. Aging-related changes in quantity and quality of saliva: where do we stand in our understanding?J Texture Stud. 2019;50(1):27-35. https://doi.org/10.1111/jtxs.12356
  21. Nederfors T, Isaksson R, Mörnstad H, Dahlöf C. Prevalence of perceived symptoms of dry mouth in an adult Swedish population‐relation to age, sex and pharmacotherapy. Community dentistry and oral epidemiology. 1997;25(3):211-6. https://doi.org/10.1111/j.1600-0528.1997.tb00928.x
  22. Liu B, Dion MR, Jurasic MM, Gibson G, Jones JA. Xerostomia and salivary hypofunction in vulnerable elders: prevalence and etiology. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;114(1):52-60. https://doi.org/10.1016/j.oooo.2011.11.014
  23. Teratani G, Awano S, Soh I, Yoshida A, Kinoshita N, Hamasaki T, et al. Oral health in patients on haemodialysis for diabetic nephropathy and chronic glomerulonephritis. Clin Oral Investig. 2013;17(2):483-9. https://doi.org/10.1007/s00784-012-0741-1
  24. Ruospo M, Palmer SC, Craig JC, Gentile G, Johnson DW, Ford PJ, et al. Prevalence and severity of oral disease in adults with chronic kidney disease: a systematic review of observational studies. Nephrol Dial Transplant. 2014;29(2):364-75. https://doi.org/10.1093/ndt/gft401
  25. Malekmakan L, Haghpanah S, Pakfetrat M, Ebrahimic Z, Hasanlic E. Oral health status in Iranian hemodialysis patients. Indian J Nephrol. 2011;21(4):235-8. https://doi.org/10.4103/0971-4065.82634
  26. Ziebolz D, Fischer P, Hornecker E, Mausberg RF. Oral health of hemodialysis patients: a cross-sectional study at two German dialysis centers. Hemodial Int. 2012;16(1):69-75. https://doi.org/10.1111/j.1542-4758.2011.00606.x
  27. Bossola M, Calvani R, Marzetti E, Picca A, Antocicco E. Thirst in patients on chronic hemodialysis: what do we know so far? Int Urol Nephrol. 2020;52(4):697-711. https://doi.org/10.1007/s11255-020-02401-5
  28. Mohammadi P, Bots CP, Brand HS. Salivary flow rate in patients with kidney failure on hemodialysis-a systematic review and meta-analysis. J Clin Med. 2025;14(17):6108. https://doi.org/10.3390/jcm14176108
  29. Al Nowaiser A, Roberts GJ, Trompeter RS, Wilson M, Lucas VS. Oral health in children with chronic renal failure. Pediatr Nephrol. 2003;18(1):39-45. https://doi.org/10.1007/s00467-002-0999-7
  30. Khabibova N, Olimova D. Incidence, etiology, and pathogenesis of oral diseases in patients on hemodialysis. J Multidiscip Sci Innov. 2025;1(1):641-3.
  31. Khanum N, Mysore-Shivalingu M, Basappa S, Patil A, Kanwar S. Evaluation of changes in salivary composition in renal failure patients before and after hemodialysis. J Clin Exp Dent. 2017;9(11):e1340-5. https://doi.org/10.4317/jced.54027
  32. Bots C, Brand H, Veerman E, Valentijn-Benz M, Henskens Y, Valentijn R, et al. Acute effects of hemodialysis on salivary flow rate and composition. Clin Nephrol. 2007;67(1):25-31. https://doi.org/10.5414/cnp67025
  33. Hamid MJAA, Dummer CD, Pinto LS. Systemic conditions, oral findings and dental management of chronic renal failure patients: general considerations and case report. Braz Dent J. 2006;17(2):166-70. https://doi.org/10.1590/S0103-64402006000200016
  34. Shetty P, Hegde MN, Eraly SM. Evaluation of salivary parameters and dental status in adult hemodialysis patients in an Indian population. J Clin Exp Dent. 2018;10(5):e419-24. https://doi.org/10.4317/jced.54633
  35. Abdulla HI, Al-Kotany MY, Mahdi KA. Assessment of oral manifestations of patients with renal failure undergoing hemodialysis by serum and salivary biomarkers. Mustansiria Dent J. 2012;9(1):118-29. https://doi.org/10.32828/mdj.v9i1.253
  36. Xie T, Yang Z, Dai G, Yan K, Tian Y, Zhao D, et al. Evaluation of the oral health status in Chinese hemodialysis patients. Hemodial Int. 2014;18(3):668-73. https://doi.org/10.1111/hdi.12149
  37. Bots CP, Poorterman JH, Brand HS, Kalsbeek H, Van Amerongen B, Veerman E, et al. The oral health status of dentate patients with chronic renal failure undergoing dialysis therapy. Oral Dis. 2006;12(2):176-80. https://doi.org/10.1111/j.1601-0825.2005.01183.x
  38. Akar H, Akar GC, Carrero JJ, Stenvinkel P, Lindholm B. Systemic consequences of poor oral health in chronic kidney disease patients. Clin J Am Soc Nephrol. 2011;6(1):218-26. https://doi.org/10.2215/CJN.05470610
  39. de la Rosa García E, Mondragón Padilla A, Aranda Romo S, Bustamante Ramírez MA. Oral mucosa symptoms, signs and lesions, in end stage renal disease and non-end stage renal disease diabetic patients. Med Oral Patol Oral Cir Bucal [Internet]. 2006[cited 2025 Dec 29];11(6). Available from: https://pubmed.ncbi.nlm.nih.gov/17072248/