IADR Abstract Archives
Periodontitis Severity Associated with Cardio-Renal Health in Renal Disease Patients
Objectives: Chronic kidney disease (CKD) affects 13% of UK adults and is associated with increased morbidity and mortality. Mechanisms involve systemic inflammation/ oxidative stress. Periodontitis may contribute to this, thereby impacting CKD-associated morbidity/mortality.
The aim of this study was to quantify the association between periodontal and cardio-renal health and to explore mechanisms underpinning these associations.
Methods: We recruited 770 patients with high-risk CKD (stage 3-5 pre-dialysis). Periodontal measurements were recorded at interproximal sites of all teeth present; kidney function was assessed using the CKD-EPI equation for estimated glomerular filtration rate (eGFR) and vascular stiffness was measured using carotid-femoral pulse-wave velocity (PWV). Plasma protein carbonyls and F2-α-isoprostanes were employed as measures of oxidative stress.
Multiple linear regression models were fit to explore the associations, accounting for differences in age, sex, ethnicity, diabetic and smoking status, BMI, BP, and socio-economic status.
Results: The mean age of participants was 63 + 16 years; 61% were male, 48% never-smokers and 37% had diabetes. According to the 2007 AAP classification of periodontitis, only 4% had mild/no periodontitis, 40% had moderate and 41% had severe periodontitis and 15% were edentulous. Measures of periodontal disease (mean probing depth/clinical attachment loss, bleeding on probing and periodontal inflamed surface area) were all significantly associated with decreasing renal function, increasing vascular stiffness, and increasing levels of oxidative stress markers in the fully adjusted model (Table1).
Conclusions: Worsening periodontal health is associated with declining renal function and increasing vascular stiffness in this large, well-characterised cohort. There was evidence of systemic oxidative damage with worsening periodontitis, therefore potential mechanisms include oxidative stress-mediated pro-inflammatory events. Therefore, treatment of periodontitis may have a beneficial impact on the general health of patients with CKD.
The aim of this study was to quantify the association between periodontal and cardio-renal health and to explore mechanisms underpinning these associations.
Methods: We recruited 770 patients with high-risk CKD (stage 3-5 pre-dialysis). Periodontal measurements were recorded at interproximal sites of all teeth present; kidney function was assessed using the CKD-EPI equation for estimated glomerular filtration rate (eGFR) and vascular stiffness was measured using carotid-femoral pulse-wave velocity (PWV). Plasma protein carbonyls and F2-α-isoprostanes were employed as measures of oxidative stress.
Multiple linear regression models were fit to explore the associations, accounting for differences in age, sex, ethnicity, diabetic and smoking status, BMI, BP, and socio-economic status.
Results: The mean age of participants was 63 + 16 years; 61% were male, 48% never-smokers and 37% had diabetes. According to the 2007 AAP classification of periodontitis, only 4% had mild/no periodontitis, 40% had moderate and 41% had severe periodontitis and 15% were edentulous. Measures of periodontal disease (mean probing depth/clinical attachment loss, bleeding on probing and periodontal inflamed surface area) were all significantly associated with decreasing renal function, increasing vascular stiffness, and increasing levels of oxidative stress markers in the fully adjusted model (Table1).
Conclusions: Worsening periodontal health is associated with declining renal function and increasing vascular stiffness in this large, well-characterised cohort. There was evidence of systemic oxidative damage with worsening periodontitis, therefore potential mechanisms include oxidative stress-mediated pro-inflammatory events. Therefore, treatment of periodontitis may have a beneficial impact on the general health of patients with CKD.