The effect of medication on the oral cavity in patients after kidney transplantation: a review

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Abstract

Organ transplantation is currently one of the most effective methods of treating end-stage chronic diseases, significantly improving patient survival and quality of life. In particular, kidney transplantation is considered the “gold standard” for treating end-stage renal disease. However, its success depends largely on lifelong immunosuppressive therapy to prevent graft rejection, which is accompanied by both systemic and local complications.

Among these, oral lesions are particularly important. They result from both the direct effects of immunosuppressive drugs on oral tissues and microbiome and from reduced immune defenses, which promote infectious processes. The most common are viral, bacterial, and fungal infections, including herpes simplex virus, cytomegalovirus, and Candida spp.

Drug-induced complications include gingival hyperplasia, stomatitis, mucositis, and xerostomia. Of particular note is hypertrophic gingivitis associated with cyclosporine and other immunosuppressants, which can significantly impair quality of life and complicate oral hygiene. Reduced salivation also promotes pathogenic microbial growth and increases the risk of inflammatory disease.

This review is the first to systematize data on the effects of current immunosuppressive regimens on the oral cavity in kidney transplant recipients, considering the relationships between the type of medication, treatment duration, and dental complications, as well as the most common drug-induced oral lesions. The need for an interdisciplinary approach to managing this patient population is emphasized.

Reading this review will provide a comprehensive understanding of the mechanisms of dental complications in kidney transplant recipients, the effects of immunosuppressive drugs on oral tissues, and the importance of timely dental monitoring. Without this review, these relationships between drug therapy and oral health would not be presented in a systematic, clinically oriented manner.

The findings highlight the need for early diagnosis, regular dental monitoring, and an interdisciplinary approach to managing this patient population. The development of unified protocols for preventing and treating oral lesions in kidney transplant recipients is an important goal for future research and clinical practice.

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About the authors

Vitaly A. Arzhantsev

Russian Medical Academy of Continuous Professional Education; Republican Dental Polyclinic

Author for correspondence.
Email: vit4937@yandex.ru
ORCID iD: 0009-0005-9523-8154
SPIN-code: 9796-3740
Russian Federation, Kazan; Kazan

Lubov R. Mukchamedzanova

Russian Medical Academy of Continuous Professional Education; Chuvash State University named after I.N. Ulyanova

Email: lr71@bk.ru
ORCID iD: 0000-0003-0752-6497
SPIN-code: 7078-4299

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Kazan; Cheboksary

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