When your kidneys aren’t working well, it can affect your whole body. You may be surprised to learn that kidney disease can cause symptoms on your tongue. Practitioners of traditional Chinese medicine even use the tongue to predict outcomes in chronic kidney disease.

If you’re living with kidney disease, including rare diseases like ​​immunoglobulin A (IgA) nephropathy, or complement 3 (C3) glomerulopathy, you should be aware of the symptoms that can affect your tongue.

How Can Kidney Disease Affect the Tongue?

Your oral (mouth) health can be impacted by factors associated with kidney disease and its treatment. In the early stages, there doesn’t seem to be an increased risk of oral or dental problems. However, as your kidney disease progresses to end-stage renal (kidney) disease, oral problems become more common.

Kidney Disease-Related Factors and Oral Health

Your kidneys are responsible for removing waste from the blood, managing extra fluid, and maintaining the balance of electrolytes (minerals) in the body. In kidney disease, your kidneys aren’t as good at managing these tasks, resulting in a buildup of waste in your blood. The excess waste products and toxins in your blood can leak into your saliva (spit) and irritate your mouth and tongue.

People with kidney diseases are also more likely to have xerostomia (dry mouth). Having dry mouth can affect how your tongue looks and feels. Kidney disease can contribute to dry mouth if harmful substances build up in the blood and damage the salivary glands. Several health problems related to kidney disease are also associated with dry mouth, including diabetes, obesity, heart disease, and hypertension (high blood pressure).

Kidney Disease Treatments and Oral Health

Dry mouth in kidney disease is also linked to certain treatments, such as dialysis, that help remove excess fluid and waste from the body. About 3 out of 4 people on dialysis report symptoms of dry mouth.

Some medications used to treat kidney disease can also increase your risk of developing mouth sores and dry mouth. Examples of common medications used to treat kidney disease that are linked to oral changes include:

• Corticosteroids
• Diuretics (water pills)
• High blood pressure medications
• Immunosuppressants

Tongue Symptoms With Kidney Disease

Kidney disease can affect your tongue in several ways. Below, we’ll review some of the most common tongue symptoms that can be related to kidney disease.

Dry Mouth

Dry mouth happens when the glands responsible for making saliva aren’t working as well as they should. Saliva has several important functions to protect your mouth and tongue. First, it helps to lubricate your mouth so your tongue doesn’t stick to it. Saliva also contains proteins that can kill harmful bacteria, preventing infection. If you get a cut or sore on your tongue, special proteins and growth factors present in saliva can promote healing.

When your mouth is dry, it also affects your tongue. Tongue symptoms of dry mouth can include:

• Dry or sticky feeling on your tongue
• Changes in your sense of taste
• Grooves on the surface of your tongue
• Sores on your tongue

You’re also more likely to develop tooth decay and cavities with dry mouth.

Changes in Taste

Kidney disease can affect your sense of taste. Decreased saliva production in dry mouth is one way kidney disease can affect your sense of taste. Uremia (high levels of urea in your blood) can also affect your sense of taste. Urea is a waste product that healthy kidneys normally filter out of the blood and into the urine. In kidney disease, urea levels can get too high if your kidney function is too low. Uremia can cause a metallic taste on your tongue. People with uremia can also have bad breath that smells like urine.

Many people with kidney disease experience changes in their sense of taste. As many as 50 percent of people with kidney disease undergoing hemodialysis (dialysis using a machine to filter the blood) report this symptom.

Tongue Sores

Ulcers (open sores) on the tongue can develop in people with kidney disease. Sores may look white or red and may be painful.

Factors related to kidney disease that may cause tongue sores include:

• Dry mouth
• Problems with the immune system
• Uremia
• Medications, such as diuretics, heart medications, and immunosuppressants

Mouth and tongue sores may be caused by other health conditions, such as stress, injury, or medications.

White Coating on the Tongue

In rare cases, uremia can cause a white coating to form on the tongue. This is known as uremic stomatitis. Other symptoms of uremic stomatitis may include:

• Pain
• Burning sensation
• Patches on the tongue that look hairy
• Dry mouth
• Taste changes

White spots on the tongue can also be caused by a fungal infection called oral thrush. People with kidney disease may be at risk of oral thrush because of a weakened immune system or other associated health problems, such as dry mouth and diabetes.

Treating Tongue Symptoms With Kidney Disease

Treating kidney disease may help improve tongue symptoms. For example, if your tongue symptoms are related to uremia, your symptoms may improve after your urea levels decrease. Dialysis can help reduce blood urea levels. Both kinds of dialysis — hemodialysis and peritoneal dialysis (which uses a special fluid to filter blood through the stomach lining) — can help improve your blood urea levels. Your healthcare team can monitor your urea levels using blood tests and urine tests. In most cases, signs of kidney disease, such as tongue symptoms, improve after starting dialysis treatment.

If you have end-stage renal disease, you may be eligible for a kidney transplant. Receiving a donor kidney can also help improve symptoms associated with poor kidney function.

Even with treatment, like dialysis, you may still have some tongue symptoms, such as dry mouth or mouth sores. It’s important to talk to a healthcare professional about the best treatment options for your symptoms.

Prescription and over-the-counter treatments are available to help with pain associated with mouth sores. To help improve dry mouth, you can try the following tips at home:

• Chew sugar-free gum.
• Take frequent sips of water.
• Try saliva substitute products.
• Avoid tobacco products.
• Limit caffeine.
• Use a humidifier.

Managing Oral Health With Kidney Disease

Just as your kidney function can affect your mouth and tongue, your oral health can also affect your kidneys. In fact, poor oral health is associated with an increased risk of experiencing complications in the first year after a kidney transplant.

Having good oral health can have a positive impact on your whole body. If you’ve been diagnosed with kidney disease, it’s important to see a dentist at least twice a year. Regular dental exams can help spot problems with your teeth, gums, and tongue before they become a bigger problem.

Talk to your dentist and nephrologist (kidney doctor) about the best treatment plan to prevent complications related to poor oral hygiene. In general, the following tips can help your mouth healthy:

• Brush your teeth twice a day.
• Use a soft-bristled toothbrush.
• Floss between your teeth at least once a day.
• Choose a toothpaste with fluoride to prevent cavities.
• Use alcohol-free mouthwash designed for dry mouth.

Talk With Others Who Understand

At MyKidneyDiseaseTeam, the site for people with kidney diseases and their loved ones, people come together to gain a new understanding of kidney diseases and share their stories with others who understand their experience.

Have you experienced any tongue symptoms since being diagnosed with kidney disease? How do you take care of your oral hygiene to prevent tongue symptoms? Share your experience in the comments below, start a conversation by posting on your Activities page, or connect with like-minded members in Groups.