СТОМАТОЛОГІЧНИЙ СТАТУС І САЛІВАРНІ ПОКАЗНИКИ У ДІТЕЙ, ЯКІ ОТРИМУЮТЬ ПРОГРАМНИЙ ГЕМОДІАЛІЗ: ПОРІВНЯЛЬНЕ ПОПЕРЕЧНЕ ДОСЛІДЖЕННЯ

Children with end-stage renal disease experience prolonged exposure to uremia, mineral metabolism disturbances, high medication burden, and repeated hemodialysis sessions. Although this cumulative burden may affect dental hard tissues, the periodontium, and the salivary environment, pediatric research findings remain inconsistent. Objective. To compare clinical dental and salivary parameters in children receiving maintenance hemodialysis with those in systemically healthy peers, and to evaluate the associations between caries severity, oral hygiene, salivary pH, and salivary flow rate. Materials and methods. This comparative cross-sectional study enrolled 90 children aged 6–12 years, comprising 60 patients undergoing maintenance hemodialysis and 30 systemically healthy controls. The decayed, missing, and filled teeth (DMFT + dmft) indices, Simplified Oral Hygiene Index (OHI-S), papillary-marginal-alveolar (PMA) index, Developmental Defects of Enamel (DDE) index, unstimulated salivary flow rate, salivary pH, and concentrations of calcium, phosphorus, urea, and creatinine were evaluated. Quantitative and categorical variables were compared using the Welch t-test and the two-sided Fisher exact test, respectively. Correlations were assessed using the Pearson correlation coefficient, with statistical significance defined as p < 0.05. The study was conducted in accordance with the Declaration of Helsinki. Pediatric enrollment required written informed consent from a parent or legal guardian, with all personal data excluded from the analysis. This study was performed as an institutional research project of the Department of Pediatric Dentistry, Bukhara State Medical Institute named after Abu Ali ibn Sino, entitled "Clinical and pathogenetic rationale for improving the diagnosis and prevention of dental diseases in children with chronic systemic diseases" (State Registration No. S/027; 2021–2025). Results. Caries (83.3% vs. 50.0%; OR 5.00; 95% CI 1.86–13.41; p = 0.002), enamel hypoplasia (56.7% vs. 20.0%; p = 0.001), enamel opacities (63.3% vs. 26.7%; p = 0.002), and xerostomia (66.7% vs. 13.3%; p < 0.001) were more frequently observed in children undergoing hemodialysis. The mean DMFT + dmft score was 6.50 ± 1.94 vs. 3.10 ± 1.10 (mean difference 3.40; 95% CI 2.76–4.04; p < 0.001), OHI-S was 2.65 ± 1.10 vs. 1.20 ± 0.55 (p < 0.001), and PMA was 45.0 ± 16.61% vs. 18.0 ± 8.22% (p < 0.001). Unstimulated salivary flow rate was lower in the hemodialysis group (0.30 ± 0.16 vs. 0.52 ± 0.22 mL/min; p < 0.001), as were salivary pH (6.30 ± 1.09 vs. 7.00 ± 0.55; p < 0.001) and calcium concentration. Salivary phosphorus, urea, and creatinine concentrations were elevated. The DMFT + dmft index was positively correlated with OHI-S (r = 0.62) and inversely correlated with salivary pH (r = −0.54) and salivary flow rate (r = −0.58; p < 0.05). Conclusions. The children receiving maintenance hemodialysis exhibited a high burden of caries, enamel defects, gingivitis, and xerostomia, accompanied by reduced unstimulated salivary flow rate and an altered mineral-metabolic salivary profile. Although the cross-sectional design precludes causal inference, these findings support regular dental monitoring as a component of multidisciplinary management in this population.