Comparative evaluation of oral Candidal flora status in patients undergoing hemodialysis and those with stage 3 and 4 chronic kidney disease

Receiving hemodialysis therapy may affect oral candidal colonization. The aim of this study was to determine presence of Candida species in the oral cavity and evaluate their prevalence and severity in patients with renal insufficiency.
Fifty end-stage renal disease (ESRD) patients who initiated their hemodialysis (HD) therapy at least 6 months prior to this research and 50 patients with chronic kidney disease (CKD) not requiring HD (control group) were invited to participate in this case control study. Oral samples were collected by swab technique from posterior-dorsal surface of the tongue and cultured on Sabouraud dextrose agar plus chloramphenicol (SC), CHROMagar Candida® (CMA) and cornmeal agar plus 1% Tween 80 (CTA) to assess the growth of yeasts, determine degree of colonization and identify species. Data analysis was performed using SPSS 18 with Pearson, chi-squared, Wilcoxon and Mann–Whitney tests and Spearman's rho (α=0.05).
Based on the results, 48% of HD subjects and 38% of CKD subjects carried Candidal yeasts, with no significant difference (p value=0.54). Candida albicans was the most predominant species isolated in both HD and CKD groups (66.6% and 84.2% respectively). Statistical analysis showed that colonization increased with age (p value=0.017, r=0.23), with no significant relationship between colonization severity and gender or time on dialysis (p value>0.05).
Under the limitations of this investigation, no difference was observed in oral Candidal colonization percentages between two study groups.