Periodontal treatment in patients with chronic kidney disease: a pilot study

• Published in: Journal of periodontal research Vol. 52; no. 2; pp. 262 - 267
• Main Authors: Almeida, S., Figueredo, C. M., Lemos, C., Bregman, R., Fischer, R. G.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.04.2017
• Subjects: Albumin; Arginine - analogs & derivatives; Arginine - blood; asymmetric dimethylarginine; Bleeding; Cholesterol; Cholesterol - blood; chronic kidney disease; Chronic Periodontitis - complications; Chronic Periodontitis - therapy; Dental Plaque Index; Dentistry; Dialysis; Endothelium; Epidermal growth factor receptors; Female; Glomerular Filtration Rate; Humans; Kidney diseases; Kidney transplantation; Male; Metabolism; Middle Aged; Oral Hygiene; Patients; Periodontal Index; Periodontal Pocket - complications; Periodontitis; Pilot Projects; Plaque index; Renal function; Renal Insufficiency, Chronic - complications; Serum Albumin - analysis; Triglycerides; Triglycerides - blood; chronic kidney disease; glomerular filtration rate; asymmetric dimethylarginine; periodontitis
• ISSN: 0022-3484; 1600-0765
• DOI: 10.1111/jre.12390

Background and Objective This pilot cohort study evaluated the effect of periodontal treatment on renal function, metabolic markers and asymmetric dimethylarginine (ADMA) in patients with pre‐dialysis chronic kidney disease (CKD) presenting chronic periodontitis. Material and Methods Twenty‐six patients with CKD and severe chronic periodontitis were selected. Periodontal parameters included plaque index, bleeding on probing, probing pocket depth and clinical attachment level. Estimated glomerular filtration rate (eGFR), triglycerides, total cholesterol, albumin and ADMA levels were evaluated at baseline, 90 and 180 d after periodontal therapy. eGFR was evaluated by the Modification of Diet in Renal Disease equation. Results All periodontal clinical parameters significantly improved (p < 0.05) 180 d after periodontal therapy. There was a significant improvement on the median values (25%; 75% percentiles) of eGFR from 34.6 (27; 44.7) mL/min/1.73 m2 on baseline to 37.6 (29.7; 57) mL/min/1.73 m2 on day 90, and to 37.6 (28.6; 56) mL/min/1.73 m2 (p < 0.05) on day 180. ADMA levels significantly reduced 180 d after periodontal treatment. No significant differences were observed at the median values of metabolic markers comparing baseline and 180 d after periodontal treatment. Conclusions The results point to a link of kidney disease with endothelium dysfunction and periodontitis, suggesting that periodontal treatment may be beneficial to the course of CKD.