End Stage Renal Disease: Not a Contraindication for Minor Oral Surgery—Protocol for the Management of Oral Surgery patients with ESRD on Hemodialysis

Abstract

Objective

To describe a safe and effective protocol for the management of patients with end stage renal disease (ESRD) undergoing minor oral surgery.

Subjects and Methods

A prospective cohort study was conducted on all patients with ESRD who were referred for dental consultation. A definite protocol was designed in consultation with the nephrologist to minimize the risk of bleeding and wound healing complications during and after the minor surgical procedures. 36 patients consented for the protocol to be followed while 4 patients did not comply with the protocol and in 2 cases the protocol could be followed. The intra operative, post operative bleeding, and the wound healing were assessed in these patients.

Results

36 patients had uneventful extractions as the blood pressure was brought down to pre hypertensive stage following the protocol. 4 patients who did not comply with the protocol had episodes of bleeding in the post operative period. There were two special scenarios where additional precautions had to be taken have been discussed. The wound healing was satisfactory in all these patients.

Conclusion

The protocol discussed in this article helps us provide safe minor oral surgical treatment in patients with ESRD.

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