Association between Periodontitis and End-stage renal disease.(A pilot study)

End-stage renal disease (ESRD) patients experience a significantly increased rate of atherosclerotic complications. Inflammation plays a central role in the pathogenesis of atherosclerotic complications. C-reactive protein (CRP), the major acute phase protein, is known to predict all-cause and cardiovascular mortality in ESRD patients. Many ESRD patients experience elevated CRP levels without an overt infection. Periodontal diseases in general population has been associated with both an increased prevalence of the atherosclerotic complications and an elevation in serum CRP values. Objective: - The main objective of the present study was to investigate whether periodontal disease is associated with increased systemic inflammation reflected by CRP values, in patients with ESRD on maintenance hemodialysis (HD) or peritoneal dialysis (PD). Methods: We conducted a cross-sectional observer blind study of 65 patients (selected randomly) with ESRD attending the renal unit at Tygerberg hospital. A physician of the renal unit recorded patient's demographics, medical history and CRP levels. A single examiner carried out the periodontal examinations. Results: 40 ESRD patients, 28 HD (70%) and 12 PD (30 %) meet the inclusion criteria. 57% were found to have periodontal disease. Patients with periodontal disease showed significantly higher levels of CRP (P=0.043) as compared to the patients without periodontal disease. Conclusion: These results show significantly elevated values of CRP in ESRD patients with periodontal disease. We concluded that periodontal diseases may be an over looked source of inflammation in ESRD patients.