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CC BY-NC-ND 4.0 · Eur J Dent 2011; 05(01): 008-018
DOI: 10.1055/s-0039-1698853
Original Article
Dental Investigation Society

Lack of Correlation between Periodontitis and Renal Dysfunction in Systemically Healthy Patients

Renata Squariz Brotto
a   Faculdade de Ciências Farmacêuticas de Araraquara – UNESP - Univ Estadual Paulista – Departamento de Análises Clínicas, SP, Brasil.
,
Regina Célia Vendramini
a   Faculdade de Ciências Farmacêuticas de Araraquara – UNESP - Univ Estadual Paulista – Departamento de Análises Clínicas, SP, Brasil.
,
Iguatemy Lourenço Brunetti
a   Faculdade de Ciências Farmacêuticas de Araraquara – UNESP - Univ Estadual Paulista – Departamento de Análises Clínicas, SP, Brasil.
,
Rosemary Adriana Chierici Marcantonio
b   Faculdade de Odontologia de Araraquara - UNESP- Univ Estadual Paulista – Departamento de Diagnóstico e Cirurgia, SP, Brasil.
,
Adriana Pelegrino Pinho Ramos
c   Laboratório de Análises Clínicas do Curso de Ciências Farmacêuticas – Universidade de Ribeirão Preto (UNAERP), São Paulo, Brasil.
,
Maria Teresa Pepato
a   Faculdade de Ciências Farmacêuticas de Araraquara – UNESP - Univ Estadual Paulista – Departamento de Análises Clínicas, SP, Brasil.
› Author Affiliations
Further Information

Publication History

Publication Date:
30 September 2019 (online)

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ABSTRACT

Objectives: The aim of this study was to assess a suggested association between periodontitis and renal insufficiency by assaying kidney disease markers. Methods: Variables used to diagnose periodontitis were: (i) probing pocket depth (PPD), (ii) attachment loss (AL), (iii) bleeding on probing (BOP), (iv) plaque index (PI) and (v) extent and severity index. Blood and urine were collected from 60 apparently healthy non-smokers (men and women), consisting of a test group of 30 subjects with periodontitis (age 46±6 yrs) and a control group of 30 healthy subjects (age 43±5 yrs). Kidney function markers (urea, creatinine, uric acid and albumin contents) were measured in the serum and urine. Also, the glomerular filtration rate was estimated from creatinine clearance, from the abbreviated Modification of Diet in Renal Disease formula and from the albumin : creatinine ratio in a 24–h sample of urine. Results: It was found that the control group had a greater mean number of teeth than the test group and that the two groups also differed in PPD, AL, BOP and PI, all these variables being higher in the test group (P=0.006). For the extent and severity index of both PPD and AL, the test group had much higher medians of both extent and severity than the control group (P=0.001). With regard to kidney function, none of the markers revealed a significant difference between the control and test groups and all measured values fell within the reference intervals. Conclusions: It is proposed that severe periodontitis is not associated with any alteration in kidney function. (Eur J Dent 2011;5:8-18)

Key words:

Kidney function markers - Creatinine clearance - Albumin - Urea - Uric acid
 

  • REFERENCES

  • 1 American Academy of Periodontology. International workshop for a classification of periodontal disease and conditions. Ann Periodontol 1999;4:1-112.
  • 2 Armitage GC. Classifying periodontal disease – a longstanding dilemma. Periodontol 2000 2002;30:9-32.
  • 3 Nishihara T, Koseki T. Microbial etiology of periodontitis. Periodontol 2000 2004;36:14-36.
  • 4 Kinane D, Bouchard P. Periodontal diseases and health: consensus report of the sixth European workshop on periodontology. J Clin Periodontol 2008;35(suppl.8):333-337.
  • 5 Jansson L, Lavstedt S, Frithiof I, Theobald H. Relationship between oral health and mortality in cardiovascular diseases. J Clin Periodontol 2001;28:762-768.
  • 6 Josiphura K, Ritchie CS. Strength of evidence relating periodontal disease and cardiovascular disease. Inside Dent 2006;2:1-9.
  • 7 Sim SJ, Kim HD, Moon JY, Zavras AI, Zdanowicz J, Jang SJ, Jin BH, Bae KH, Paik DI, Gouglass CW. Periodontitis and the risk for non-fatal stroke in Korean adults. J Periodontol 2008;79:1652-1658.
  • 8 Tuominen R, Reunanen A, Paunio M, Paunio J, Aromaa A. Oral health indicators poorly predict coronary heart disease deaths. J Dent Res 2003;82:713-718.
  • 9 Kshirsagar AV, Moss KL, Elter JR, Beck JD, Offenbacher S, Falk RJ. Periodontal disease is associated with renal insufficiency in the atherosclerosis risk in communities (ARIC) study. Am J Kidney Dis 2005;45:650-657.
  • 10 Scannapleco FA, Panesar M. Periodontitis and chronic kidney disease. J Periodontol 2008;79:1617-1619.
  • 11 Fisher MA, Taylor GW. A prediction model for chronic kidney disease includes periodontal disease. J Periodontol 2009;80:16-23.
  • 12 DeBowes LJ, Mosier D, Logan E, Harvey CE, Lowry S, Richardson DC. Association of periodontal disease and histopathologic lesions in multiple organs from 45 dogs. J Vet Den 1996;13:57-60.
  • 13 Yamalik N, Delilbasi L, Gulay H, Caglayan F, Haberal M, Caglayan G. The histological investigation of gingiva from patients with chronic renal failure, renal transplants, and periodontitis: a light and electron microscopic study. J Periodontol 1991;62:737-744.
  • 14 Rahman MM, Caglayan F, Rahman B. Periodontal health parameters in patients with chronic renal failure and renal transplants receiving immunosuppressive therapy. J Nihon Univ Sch Dent 1992;34:265-272.
  • 15 Fisher MA, Taylor GW, Shelton BJ, Jamerson KA, Rahman M, Ojo AO, Sahgal AR. Periodontal disease and other nontraditional risk factors for CKD. Am J Kidney Dis 2008;51:45- 52.
  • 16 Delaney MP, Price CP, Newman DJ, Lamb E. Kidney disease. In: Burtis CA, Ashwood ER, Bruns DE, eds. Tietz textbook of clinical chemistry and molecular diagnosis. 4th ed. St Louis: Elsevier Saunders, 2006:1671-1746.
  • 17 Nogueira DM, Strufaldi B, Hirata MH, Abdalla DSP, Hirata RDC. Exploração funcional do rim. In: Nogueria DM, eds. Métodos de bioquímica clínica: técnica e interpretação. São Paulo: Pancast, 1990:139-151.
  • 18 National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Part 2. Am J Kidney Dis 2002;39:S79-S92.
  • 19 Alves MAR. Diagnóstico de doença renal crônica: avaliação de proteinúria e sedimento urinário. J Bras Nefrol 2004;26:6-7.
  • 20 Machtei EE, Christersson LA, Grossi SG, Dunford R, Zambon JJ, Genco RJ. Clinical criteria for the definition of “Established Periodontitis”. J Periodontol 1992;63:207-215.
  • 21 Beck JD, Offenbacher S. Relationships among clinical measures of periodontal disease and their associations with systemic markers. Ann Periodontol 2002;7:70-89.
  • 22 Pearson TA, Mensah GA, Alexander RW, Anderson JL, Cannon RO, Criqui M, Fadl YY, Fortmann SP, Hong Y, Myers GL, Rifai N, Smith Jr SC, Taubert K, Tracy RP, Vinicor F. Markers of inflammation and cardiovascular disease: application to clinical and public health practice: a statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation 2003;107:499-511.
  • 23 Haffajee AD, Bogren A, Hasturk H, Feres M, Lopez NJ, Socransky SS. Subgingival microbiota of chronic periodontitis subjects from different geographic locations. J Clin Periodontol 2004;31:996-1002.
  • 24 Carlos JP, Wolfe MD, Kingman A. The extent and severity index: a simple method for use in epidemiologic studies of periodontal disease. J Clin Periodontol 1986;13:500-505.
  • 25 Lamb E, Newman DJ, Price CP. Kidney Function Tests. In: Burtis CA, Ashwood ER, Bruns DE, eds. Tietz textbook of clinical chemistry and molecular diagnostics. 4th ed. St. Louis: Elsevier Saunders, 2006:797-835.
  • 26 Johnson AM. Amino acids, peptides, and proteins. In: Burtis CA, Ashwood ER, Bruns DE, eds. Tietz textbook of clinical chemistry and molecular diagnostics. 4th ed. St. Louis: Elsevier Saunders, 2006:533-595.
  • 27 Roberts LW, MC Millin GA, Burtis CA, Bruns DE. Reference information for the clinical laboratory. In: Burtis CA, Ashwood ER, Bruns DE, eds. Tietz textbook of clinical chemistry and molecular diagnostics. 4th ed. St. Louis: Elsevier Saunders, 2006:2251-2318.
  • 28 Owen JA, Iggo B, Scandrett FF, Steward CP. The determination of creatinine in plasma serum, and in urine; a critical examination. Biochem J 1954;58:426-437.
  • 29 Shephard MD, Penberthy LA, Fraser CG. Short- and longterm biological variation in analytes in urine of apparently healthy individuals. Clin Chem 1981;27:569-573.
  • 30 Johnson CA, Levey AS, Coresh J, Levin A, Lau J, Eknoyan G. Clinical practice guidelines for chronic kidney disease in adults: Part I. Definition, disease stages, evaluation, treatment, and risk factors. Am Fam Physician 2004a;70:869-876.
  • 31 Johnson CA, Levey AS, Coresh J, Levin A, Lau J, Eknoyan G. Clinical practice guidelines for chronic kidney disease in adults: Part II. Glomerular filtration rate, proteinuria, and other markers. Am Fam Physician 2004b;70:1091-1097.
  • 32 Brotto RS Evaluation of the cardiovascular risk on subjects with periodontitis [Masters Dissertation] [Internet]. Araraquara: Faculty of Pharmaceutical Sciences, UNESP; 2007 Available at http://dominiopublico.gov.br Accessed August 25, 2009.
  • 33 Socransky SS, Haffajee AD, Cugini, MA, Smith C, Kent Jr RL. Microbial complexes in subgingival plaque. J Clin Periodontol 1998;25:134-144.
  • 34 Sendy J, Horta E, Foltán R, Spackova J, Dusková J. Mechanism of increased mortality in hemodialysed patients with periodontitis. Med Hypotheses 2009; about 3 p.
  • 35 Black RM. Rose & Black's Clinical problems in nephrology. Boston: Little, Brown and Company, 1996.
  • 36 Sacks DB. Carbohydrates In: Burtis CA, Ashwood ER, Bruns DE, eds. Tietz textbook of clinical chemistry and molecular diagnostics. 4th ed. St Louis: Elsevier Saunders, 2006. p.837- 901.
  • 37 Barbudo-Selmi GR, Carvalho MB, Selmi AL, Selmi AL, Martins SEC. Periodontal disease characterization in dogs with normal renal function or chronic renal failure. Ciênc Rural 2004;34:113-118.
  • 38 Leivadaros E, Van der Velden U, Bizarro S, Tem Heggeler JMAG, Gerdes VEA, Hoek FJ, Nagy TOM, Scholma J, Bakker SJL, Gans ROB, Tem CH, Loos BG. A pilot study into measurements of markers of atherosclerosis in periodontitis. J Periodontol 2005;76:121-128.
  • 39 Taylor BA, Tofler GH, Carey HMR, Morel-Kopp MC, Philcox S, Carter TR, Elliot MJ, Kull AD, Ward C, Schenck K. Full-mouth tooth extraction lowers systemic inflammatory and thrombotic markers of cardiovascular risk. J Dent Res 2006;85:74-78.
  • 40 Yoshihara A, Deguchi T, Hanada N, Miyazaki H. Renal function and periodontal disease in elderly Japanese. J Periodontol 2007;78:1241-1248.
  • 41 Kshirsagar AV, Offenbacher S, Moss KL, Barros SP, Beck JD. Antibodies to periodontal organisms are associated with decreased kidney function. The dental atherosclerosis risk in communities study. Blood Purif 2007;25:125-132.
  • 42 Vesterinen M, Ruokonen H, Leivo T, Honkanen AM, Honkanen E, Karj K, Lindqvist C, Meurman JH. Oral health and dental treatment of patients with renal disease. Quintessence Int 2007;38:211-219.
  • 43 Davidovich E, Schwarz Z, Davidovitch M, Eidelman E, Bimstein E. Oral findings and periodontal status in children, adolescents and young adults suffering from renal failure. J Clin Periodontol 2005;32:1076-1082.
  • 44 Bayraktar G, Kurtulus T, Duraduryan A, Cintan S, Kazancioglu, Yildiz A, Bural C, Bozfakioglu S, Besler M, Trablus S, Issever H. Dental and periodontal findings in hemodialysis patients. Oral Dis 2007;13:393-397.
  • 45 Borawski J, Wilczynska-Borawska M, Stokowska W, Mysliwiec M. The periodontal status of pre-dialysis chronic kidney disease and maintenance dialysis patients. Nephrol Dial Transplant 2007;22:457-464.
  • 46 Castillo A, Mesa F, Liébana J, Garcia-Martinez O, Ruiz S, Garcia-Valdecasas J, O–Valle F. Periodontal and oral microbiological status of an adult population undergoing haemodialysis: a cross-sectional study. Oral Dis 2007;13:198- 205.
  • 47 Shultis WA, Weil EJ, Looker HC, Curtis JM, Shlossman M, Genco RJ, Knowler WC, Nelson RG. Effect of periodontitis on overt nephropathy and end-stage renal disease in type 2 diabetes. Diabetes Care 2007;30:306-311.
  • 48 Felig P, Bergman M. The endocrine pancreas: Diabetes mellitus. In: Felig P, Baxter JD, Frohman LA, eds. Endocrinology and Metabolism. 3rd ed. New York: McGraw-Hill Inc, 1995:1107-1250.