# Association between Oral Streptococcus Mutans Counts and Proteinuria in Patients with Chronic Kidney Disease: A Pilot Study Using Chlorhexidine

## TL;DR

This study explores how reducing oral bacteria with mouthwash may lower proteinuria in patients with chronic kidney disease.

## Contribution

A novel pilot study linking oral Streptococcus mutans levels to proteinuria in CKD patients using chlorhexidine.

## Key findings

- Higher initial S. mutans counts correlated with higher proteinuria in CKD patients.
- After 12 months of chlorhexidine use, both S. mutans and proteinuria levels decreased significantly.
- Patients with lower S. mutans counts after 12 months had better proteinuria outcomes.

## Abstract

Chlorhexidine mouthwash is one of the most widely used anti-microbial agents, reducing oral cavity bacterial load. However, the effects of mouthwash on systemic conditions in patients with chronic kidney disease (CKD) remain unknown. We examined the relationship between Streptococcus mutans abundance in the oral cavity and proteinuria in patients with CKD.

Patients with CKD (n = 57) gargled with mouthwash containing chlorhexidine gluconate three times daily for 1 year. We prospectively investigated the relationship between changes in the number of S. mutans and proteinuria.

The number of S. mutans colony-forming units (CFU) ≥103/mL saliva at month 0 was significantly associated with higher urinary proteinuria and S. mutans CFU/mL over time. The mean number of S. mutans in all patients decreased significantly after 12 months. Proteinuria also decreased significantly after 12 months compared with after 6 months. The rate of proteinuria <0.3 g/g creatinine after 12 months was significantly higher in the group that had <103 CFU/mL S. mutans after 12 months than in other groups.

In this pilot study, a potential association was observed between oral S. mutans counts and proteinuria in patients with CKD. Larger studies are needed to clarify this relationship.