Nickan Research Institute Journal of Renal Injury Prevention 2345-2781 14 4 2025 12 01 Oral microbiota in hemodialysis patients; a narrative review on recent ideas e38685 e38685 10.34172/jrip.2025.38685 EN Mayyadah Hameed Rashid https://orcid.org/0009-0000-5029-1502 Haifaa Abdulameer Radhi https://orcid.org/0000-0002-9961-8497 Aseel Abdulameer Radhi https://orcid.org/0000-0003-2039-1339 Journal Article 10.34172/jrip.2025.38685 2025 08 07 2025 10 14 Alterations in oral microbiota can significantly affect systemic health in hemodialysis (HD) patients. Oral dysbiosis contributes to inflammation, production of uremic toxins, and microbial translocation, which can exacerbate cardiovascular disease, chronic kidney disease (CKD), malnutrition, and cognitive impairment. In addition, oxidative stress from periodontal bacteria exacerbates CKD by promoting systemic inflammation, increasing renal oxidative damage, and accelerating functional decline. Conversely, the persistent oxidative stress caused by periodontal bacteria creates a hostile microenvironment in the kidneys, characterized by mitochondrial impairment, membrane damage, disrupted calcium homeostasis, DNA and protein damage, and chronic inflammation. These factors collectively inhibit renal tissue repair mechanisms, accelerating renal failure progression and worsening of kidney outcomes. Managing oral health through good oral hygiene, dietary modifications, and interventions such as probiotics and prebiotics is crucial for improving the overall health and quality of life for HD patients.