Non communicable diseases (NCDs) affect the life of an individual in terms of mortality, morbidity and financial crises. Main NCDs are diabetes mellitus (DM), cardiovascular diseases (CVD), pulmonary diseases, osteoporosis and chronic kidney diseases (CKD). About 40% of the total deaths can be controlled by eliminating the risk factors for NCDs. Periodontitis have recently been labeled as an important potential risk factor for NCDs. CKD affect the oral health status of patients by inducing gingival hyperplasia, xerostomia, calcification of root canals and delayed eruption of teeth. Periodontitis increases systemic inflammatory burden leading to worsening of CKD which in turn has been has been found to negatively affect CKD of patients on hemodialysis therapy by altering their serum albumin and C-reactive protein levels. As hypoalbuminemia leads to increased mortality in CKD patients, it needs to be avoided by reducing systemic inflammatory burden in patients receiving HD therapy. Treating periodontal disease could be one factor that might decrease the systemic inflammatory burden and thereby improve quality of life of these patients. Sources of Data: Data from descriptive, cross sectional and longitudinal studies published between 2000 and 2012 were included. Data searches based on human studies only. Data Extraction: The key words, periodontitis, chronic kidney disease and hemodialysis, on MEDLINE, approximately 120 studies were identified. 35 of them were relevant to all three keywords. Most of them were cross sectional studies and total 7 clinical trials were identified regarding checking of serum levels after periodontal therapy with variable results. Conclusion: Patients with CKD have higher prevalence of periodontal disease while non-surgical periodontal therapy has been indicated to decrease the systemic inflammatory burden in patients with CKD specially those undergoing HD therapy.

Chronic kidney disease is a worldwide public health problem and a chronic disease that deteriorates the quality of life (QOL). Diabetes is recognized as co-morbidity in patients of end stage renal disease (ESRD). This study evaluated QOL in diabetic and non-diabetic patients on maintenance dialysis therapy. A cross-sectional study was conducted on ESRD with or without diabetes on hemodialysis therapy for at least three months at Kidney Center, Sheikh Zayed Medical Complex, Lahore Pakistan. QOL was assessed using WHOQOL-BREF questionnaire by World Health Organization. One hundred and thirty seven (n=137) hemodialysis patients were observed. 59 (41.8%) were with diabetes mellitus (DM) and 78 (55%) were without DM. 81 (54%) were on hemodialysis for more than 2 years. There was no statistically significant (p≥0.066) difference in QOL scores of hemodialysis patients with or without diabetes; however, a significant (p≤0.025) difference was observed in responses of 'meaningfulness' and "ability to concentrate" by patients of both groups. The scores were divided in two categories of '≤50' and '>50'; a significant (p≤0.047) difference between two groups was observed in physical domain only. The current study on diabetic and non-diabetic hemodialysis patients showed no statistical difference in their QOL except for "meaningfulness of life" and "ability to concentrate".