Periodontal Disease: A Covert Source of Inflammation in Chronic Kidney Disease Patients

Abstract

The prevalence of atherosclerotic complications (myocardial infarction, stroke, and sudden death) is increased in end-stage renal disease (ESRD) patients, especially in haemodialysis patients. Increasing evidence suggests that both in general population and in dialysis patients, systemic inflammation plays a dominant role in the pathogenesis of atherosclerotic complications. In general population, also, evidence shows that moderate to severe periodontitis can contribute to inflammatory burden by increasing serum CRP levels and may increase the prevalence of atherosclerotic events. Moreover, the results of some new interventional studies reveal that effective phase I periodontal therapy may decrease serum CRP levels, the most important acute phase protein, monitored as a systemic marker of inflammation and endothelial dysfunction as well, used as an initial predictor of atherosclerotic events. Considering that moderate to severe periodontal diseases have a higher prevalence in CKD and in dialysis population and that periodontal examination is not part of the standard medical assessment, destructive periodontitis might be an ignored source of systemic inflammation in end-stage renal disease patients and may add to the chronic inflammatory status in CKD.

Advanced drug delivery approaches against periodontitis

“…According to WHO, 10-15% of the global population possesses severe periodontitis (Jacob, 2012). A massive count of microorganisms is present in buccal cavity, but not all are pathogenic (Ismail et al, 2013). Many live in symbiosis with the healthy host (Pihlstrom et al, 2005;Singh et al, 2012a).…”

“…Many live in symbiosis with the healthy host (Pihlstrom et al, 2005;Singh et al, 2012a). With the progress in the severity of the disease, there is a shift in the type of microorganisms involved from gram-positive aerobic species in healthy individuals to gram-negative anaerobic species in periodontitis patients (Ismail et al, 2013). The organisms mainly responsible for periodontitis are gram-negative anaerobic microflora.…”

Periodontal Status of Patients Undergoing Hemodialysis Therapy in a Tertiary Level Hospital of Nepal

“…Periodontal disease has been found to be moderate to severe in renal failure patients [9][10][11][12] but there are few contradictory findings. [13][14] Chronic inflammation like periodontitis in cardiovascular diseases may aggravate the renal condition of the patients.…”

Tobacco-gene activity profile in Porphyromonas gingivalis, Filifactor alocis and Treponema denticola.

“…They represent a group of infectious inflammatory diseases affecting the supporting and surrounding tissues of teeth (53). They are second to dental caries as a cause of tooth loss among adults in developed countries (54), affecting 47.2% adults aged 30 years and older in the US (55).…”