Lack of Correlation between Periodontitis and Renal Dysfunction in Systemically Healthy Patients

Abstract

Objectives:The aim of this study was to assess a suggested association between periodontitis and renal insufficiency by assaying kidney disease markers.Methods:Variables used to diagnose periodontitis were: (i) probing pocket depth (PPD), (ii) attachment loss (AL), (iii) bleeding on probing (BOP), (iv) plaque index (PI) and (v) extent and severity index. Blood and urine were collected from 60 apparently healthy non-smokers (men and women), consisting of a test group of 30 subjects with periodontitis (age 46±6 yrs) and a control group of 30 healthy subjects (age 43±5 yrs). Kidney function markers (urea, creatinine, uric acid and albumin contents) were measured in the serum and urine. Also, the glomerular filtration rate was estimated from creatinine clearance, from the abbreviated Modification of Diet in Renal Disease formula and from the albumin : creatinine ratio in a 24–h sample of urine.Results:It was found that the control group had a greater mean number of teeth than the test group and that the two groups also differed in PPD, AL, BOP and PI, all these variables being higher in the test group (P=0.006). For the extent and severity index of both PPD and AL, the test group had much higher medians of both extent and severity than the control group (P=0.001). With regard to kidney function, none of the markers revealed a significant difference between the control and test groups and all measured values fell within the reference intervals.Conclusions:It is proposed that severe periodontitis is not associated with any alteration in kidney function.

Periodontitis and chronic kidney disease: a systematic review of the association of diseases and the effect of periodontal treatment on estimated glomerular filtration rate

“…, , Brotto et al. ). As a result, three studies presented a high methodological quality (3/5) and two a medium methodological quality (2/5) (Appendix S4).…”

“…Brotto et al. () – The authors did not find statistically significant differences ( p > 0.05) between periodontally healthy subjects and those with chronic periodontitis, concerning mean values of serum levels (albumin [g/dl] control [C]:4.9, test [T]:4.7; creatinine [mg/dl] C:0.9, T:1.0; uric acid [mg/dl] C:4.3, T:4.9), urinary levels (creatinine [mg/kg.24 h] C:18.4, T:17.1; uric acid [mg/24] C:542.2, T:526.5; urea [g/24 h] C:25.9, T: 24.5) and eGFR (creatinine clearance [ml/min/1.73 m 3 ] C:93.7, T:85.3; Modification of Diet in Renal Disease Formula [ml/min/1.73 m 3 ] C:81.3, T:78.2; albumin/urinary creatinine [mg/g] C:4.9, T:5.5). OR was not calculated in this study.…”

“…With respect to the presence of bacteria in the bloodstream, circulating periodontal bacteria could lead to kidney endothelium damage (Brotto et al. , Grubbs et al. ).…”

“…As a consequence, and since the link between chronic systemic inflammation and CKD is measured by the levels of C-reactive protein, periodontitis as a source of "permanent inflammation" could contribute to CKD (Fisher et al 2008). With respect to the presence of bacteria in the bloodstream, circulating periodontal bacteria could lead to kidney endothelium damage (Brotto et al 2011, Grubbs et al 2011. It seems biologically plausible that such an association could constitute a source of systemic inflammatory burden.…”

Association between periodontitis and chronic kidney disease: Systematic review and meta‐analysis

“…Most of the included studies demonstrated an association between CKD and periodontitis, with ORs ranging from 1.39 (1.03–1.89) (Han et al., ) to 4.0 (2.7–5.9) (Sharma et al., ). When considering the type of study, all the cohort studies found an association between CKD and periodontitis (Grubbs et al., ), (Grubbs et al., ) (Iwasaki et al., ), whereas, some cross‐sectional (Messier et al., ) and case–control (Brotto et al., ) studies failed to find it. Interestingly, higher ORs were estimated when severe forms of periodontitis were considered (OR = 2.14; CI: 1.19–3.85) (Kshirsagar et al., ).…”