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Oral health care considerations for patients with kidney/renal disease

  • Consult the patient’s nephrologist about the severity of kidney disease. Also, see relevant laboratory values that may suggest renal failure.
  • Address any underlying medical condition or disease. Increased risk of cardiac arrest and congestive heart failure (CHF).
  • Do not measure blood pressure in the arm with vascular access in patients with hemodialysis.
  • If possible, treat hemodialysis patients on days they are not receiving hemodialysis.
  • Be aware of possible increased bleeding tendencies.
  • Antibiotic prophylaxis is only indicated if a hemodialysis patient has a history of previous infective endocarditis.
  • No special dental modifications necessary for patients qwith peritoneal dialysis.
  • Avoid using aminoglycosides, tetracyclines, cephalosporins, and ibuprofen.
  • Change the dosage regimen for aspirin to q 4-6 h.
  • Change the dosage regimen for amoxicillin according to a patient’s creatinine clearance:
    CrCl >30 ml/min – no adjustment needed;
    CrCl 10-30 ml/min – 250-500 mg PO every 12 h, do not use 875 mg tablet strength or the extended release tabs;
    CrCl <10 ml/min – 250-500 mg PO every 24 h, do not use 875 mg tablet strength or the extended release tabs.

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