IADR Abstract Archives
Impact of Periodontitis on Mortality in Chronic Kidney Disease Patients
Objectives: Chronic Kidney Disease (CKD) is associated with an increased rate of mortality, which rises with increased systemic inflammation. As periodontitis represents an occult source of inflammation in patients, we hypothesised that periodontitis might negatively impact on mortality rate in patients with CKD. Therefore, our aim was to quantify the impact of periodontitis on mortality in CKD patients and to compare this with the impact of traditional risk factors (diabetes, smoking and hypertension).
Methods: Survival analysis was carried out using publically available data from the Third National Health and Nutrition Examination Survey 1988-1994 (NHANES III) and linked mortality data. Data were collected on kidney function, periodontal health and a range of covariates such as age, sex, ethnicity, blood pressure, history of cardiovascular events, diabetic status, smoking status, alcohol consumption, serum cholesterol, height, weight and measures of socio-economic status.
CKD was defined as an eGFR<60ml/min/1.73m2 (stages 3-5 CKD); periodontitis was defined using the 2007 CDC/AAP classification.
Cox proportional hazards (PH) regression analysis was carried out for all-cause and cardiovascular mortality accounting for the complex survey design of NHANES III and adjusting for potential confounders.
Results: Data was available for 13,784 participants and 861 (6%) fulfilled criteria for stages 3-5 CKD. The mean follow-up time was 13 years, during which time 80% of patients with CKD died. Cox PH regression demonstrated that periodontitis was independently associated with an increase in all-cause and cardiovascular mortality (Table 1). Associations of similar strength were found with diabetes, hypertension, and smoking.
Conclusions: In patients with CKD, the co-morbid presence of periodontitis is associated with an increased mortality rate. The strength of the association is similar to that of established, traditional risk factors of mortality in CKD. Interventional studies are required to assess the impact of treatment of periodontitis on the short and long term outcomes in patients with CKD.
Methods: Survival analysis was carried out using publically available data from the Third National Health and Nutrition Examination Survey 1988-1994 (NHANES III) and linked mortality data. Data were collected on kidney function, periodontal health and a range of covariates such as age, sex, ethnicity, blood pressure, history of cardiovascular events, diabetic status, smoking status, alcohol consumption, serum cholesterol, height, weight and measures of socio-economic status.
CKD was defined as an eGFR<60ml/min/1.73m2 (stages 3-5 CKD); periodontitis was defined using the 2007 CDC/AAP classification.
Cox proportional hazards (PH) regression analysis was carried out for all-cause and cardiovascular mortality accounting for the complex survey design of NHANES III and adjusting for potential confounders.
Results: Data was available for 13,784 participants and 861 (6%) fulfilled criteria for stages 3-5 CKD. The mean follow-up time was 13 years, during which time 80% of patients with CKD died. Cox PH regression demonstrated that periodontitis was independently associated with an increase in all-cause and cardiovascular mortality (Table 1). Associations of similar strength were found with diabetes, hypertension, and smoking.
Conclusions: In patients with CKD, the co-morbid presence of periodontitis is associated with an increased mortality rate. The strength of the association is similar to that of established, traditional risk factors of mortality in CKD. Interventional studies are required to assess the impact of treatment of periodontitis on the short and long term outcomes in patients with CKD.