Association between Chronic Periodontal Disease and Left Ventricular Hypertrophy in Kidney Transplant Recipients

Abstract

Periodontal disease (PD) may cause a systemic inflammatory reaction and contribute to left ventricular hypertrophy (LVH) in hypertensive subjects. This study aimed to assess whether chronic PD may contribute to LVH in patients after kidney transplantation. The study analyzed 99 patients divided according to Community Periodontal Index of Treatment Needs (CPITN) score into patients with advanced PD (CPITN 3-4) and patients without or with moderate periodontal lesions (CPITN 0-2). Patients with CPITN 3 to 4 were characterized by a significantly higher plasma high-sensitivity C-reactive protein (HS-CRP) concentration (6.2+/-2.2 vs. 1.7+/-0.3 mg/L, P<0.05) and left ventricular mass index (LVMI) (150+/-7 vs. 111+/-3 g/m, P<0.001) in comparison with patients with CPITN 0 to 2. In the multiple regression model, LVMI was dependent on CPITN (P<0.001), HS-CRP (P<0.05), serum cholesterol (P<0.05), and creatinine concentration (P<0.05). In conclusion, it appears that advanced PD in patients after kidney transplantation is associated with LVH.

Association of Chronic Periodontitis With Left Ventricular Mass and Central Blood Pressure in Treated Patients With Essential Hypertension

“…This is consistent with previous results. 4,[12][13][14] It has to be mentioned that because of relatively low number of patients the adjusting may have attenuated the association between LVMI and CPITN so that it was only borderline significant. If only age, sex, CPITN, and duration of hypertension have been left in the model, the association between LVMI and CPITN was highly significant (P < 0.01).…”

“…1,11 It is also known that subjects with advanced CP are characterized by increased left ventricular mass (LVM). [12][13][14] However, the reason for this increase is not clear. A simple path that leads from increased arterial stiffness caused by inflammatory cytokines-induced arteriosclerosis, to a resultant increase of blood pressure and at the end to increased LVM, is not confirmed.…”

Aortic Stiffness and Central Wave Reflections Predict Outcome in Renal Transplant Recipients

“…7 In the present study, high-sensitivity CRP remained an independent predictor of CV events, indicating that the adverse effect of microinflammation is only partially explained by its relationship with pulsatile hemodynamics. Low-grade inflammation in RTRs may represent a residual effect from before transplantation or be due to sources other than those encountered in the dialysis stage, such as chronic allograft nephropathy, 24 periodontal disease, 25 or treatment with sirolimus. 26 In view of the adverse impact of subclinical inflammation, these sources should be searched for and remediated if present.…”

Local and Systemic Up-regulation of TNFα, IL-1β and IL-6 in Mice Intratracheally Inoculated with Porphyromonas gingivalis

“…Formation of cytotoxic iron-nytrosyl-sulphur complexes may occur, inhibiting Fe-dependent enzymes and damaging the DnA of the cells in kidneys (Cook and Sullivan 1991). Cytokines may lead to coagulation abnormalities and induce metabolic changes in endothelial cells (nieto 1998;Franek et al 2005). Similarly, cytokines may also influence metabolism in glomerular mesangial cells (Sedor et al 1993).…”