General medicine and surgery for dental practitioners Part 7: Renal disorders

Renal patients may have impaired drug excretion. Drugs used in dental sedation and general anaesthesia should be used with caution and in consultation with a physician.Renal disease influences the use of other drugs in dentistry, particularly NSAIDS and some antimicrobialsPlatelet dysfunction may occur in renal patients giving rise to a bleeding tendency. Patients on haemodialysis may be heparinised. Dental treatment should be carried out on the day after dialysis. Renal condition is optimal at this time and the anticoagulant effect has stopped.The arm with vascular access for dialysis (the surgically created arterio-venous fistula) should not be used for venepuncture by the dentist.Patients who have had a kidney transplant may need corticosteroid cover, have a bleeding tendency if anticoagulated, may have gingival hyperplasia if taking ciclosporin and are prone to infection due to immunosuppression.