Chewing ability and its associated factors in maintenance hemodialysis patients: a cross-sectional study

Chewing difficulty is prevalent yet understudied in maintenance hemodialysis (MHD) patients, despite its critical role in overall health. This study aimed to investigate the current status of chewing ability and its associated factors in Chinese MHD patients. A cross-sectional study was conducted at a tertiary hospital in Chengdu from July to October 2024. Chewing ability was objectively assessed using color-changeable gum, with grades 1–2 defining decreased function. Other variables included general information, anxiety and depression symptoms, nutritional status, and activity of daily life (ADL). Multivariable logistic regression identified the factors influencing chewing ability. A total of 154 MHD patients aged ≥ 55 years were included in this study, and the prevalence of decreased chewing ability was 27.3%. Associated factors included: number of remaining teeth < 20 (OR = 4.66, 95%CI: 1.91–11.35), subjective chewing difficulty (OR = 3.40, 95%CI: 1.22–9.44), low articulatory oral motor skills (OR = 3.65, 95%CI: 1.47–9.10), and malnutrition (OR = 4.91, 95%CI: 1.82–13.27) (P < 0.05). MHD patients are more likely to have decreased chewing ability than the general population. HD staff can provide comprehensive management based on oral status examinations, self-reports of oral health outcomes, and validated nutritional screenings.