Association Of Periodontal Inflammatory Burden With Salivary MMP-8 Concentration Among Chronic Kidney Disease Patients At Predialysis Stage

Objectives: Our aim was to analyze salivary MMP-8 concentrations with respect to oral/periodontal inflammation in chronic kidney disease (CKD) patients at predialysis stage. We hypothesized that diabetic patients have increased values compared with those of other etiology.
Methods: This is further research of our cross-sectional, retrospective study of 144 adult predialysis patients (Vesterinen et al. 2011). Clinical and radiographic oral health examinations were made at Helsinki University Hospital (HUCH), Finland. Salivary samples available from 118 of 144 patients were examined for MMP-8 by immune fluorometric assay. Of the patients, 43 (36%) had diabetic nephropathy, while 75 (64%) had other kidney disease. Oral and general health data including laboratory findings, periodontal inflammatory burden index (PIBI), and total dental index (TDI) were recorded from hospital records. Results between groups were analyzed with cross tabulation, Pearson Chi-square test, and Mann-Whitney test.
Results: Elevated PIBI, increased TDI, and two or more sites with ≥ 6mm periodontal pockets (severe periodontitis) associated with increased salivary MMP-8, (p<0.05). Moderate periodontitis (two or more teeth with ≥ 5mm pocket depth) and bone loss up to apical thirds of root lengths also associated with higher median of MMP-8 concentration (≥135 ng/ml), (p<0.05). Diabetic nephropathy group had slightly, but not significantly elevated median salivary MMP-8 concentration (149 ng/ml) compared with other CKD group (116 ng/ml).

Conclusions: Elevated salivary concentration of MMP-8 associated with more severe markers of oral/periodontal inflammation among the patients but with no significant difference between diabetic vs. other CKD patients. MMP-8 analysis could give adjunctive information of oral health within this special group of patients. Supported by EVO grant TYH2013334 from the HUCH.