Clinical characteristics of pain syndromes in dental practice among patients with chronic kidney disease

The analysis of the etiology, pathogenesis and clinical features of the appearance of pain syndrome in the maxillofacial region in patients with chronic kidney disease is presented. The mechanisms of the effect of uremic intoxication on the oral mucosa and the peripheral nervous system are considered. Specific conditions such as uremic stomatitis, trigeminal neuropathy, and burning mouth syndrome have been identified. Special attention is paid to the manifestations of bone mineral disorders (CKD-MBD), including renal osteodystrophy of the jaws. The approach to pharmacological pain relief is systematized: a strict ban on the use of nonsteroidal anti-inflammatory drugs (NSAIDs) is justified and algorithms for the safe dosing of analgesics and adjuvants (gabapentinoids) are proposed, taking into account the reduced glomerular filtration rate and dialysis clearance. Clinical recommendations on dental treatment tactics, including hemostasis measures and timing of hemodialysis sessions to minimize the risks of complications, are also formulated.