Fisher Monica A, Taylor George W, Shelton Brent J, Jamerson Kenneth A, Rahman Mahboob, Ojo Akinlolu O, Sehgal Ashwini R
Case Western Reserve University, Cleveland, OH 44106-4905, USA.
Am J Kidney Dis. 2008 Jan;51(1):45-52. doi: 10.1053/j.ajkd.2007.09.018.
Chronic kidney disease, undiagnosed in a significant number of adults, is a public health problem. Given the systemic inflammatory response to periodontal disease, we hypothesized that periodontal disease could be associated with chronic kidney disease.
Cross-sectional.
SETTING & PARTICIPANTS: We identified 12,947 adults 18 years or older with information for kidney function and at least one risk factor in the Third National Health and Nutrition Examination Survey.
The main predictor was periodontal status. Other nontraditional and traditional risk factors included socioeconomic status, health status, health behavior, biomarker levels, anthropometric assessment, and health care utilization.
OUTCOMES & MEASUREMENTS: Chronic kidney disease was defined using the Kidney Disease Outcomes Quality Initiative stages 3 and 4 with a moderate to severe decrease in kidney function (glomerular filtration rate, 15 to 59 mL/min/1.73 m(2)). Univariable and multivariable logistic regression models assessed the associations between chronic kidney disease and periodontal disease and other nontraditional risk factors.
Chronic kidney disease prevalence was 3.6%; periodontal disease prevalence was 6.0%; and edentulism prevalence was 10.5%. Adults with periodontal disease and edentulous adults were twice as likely to have chronic kidney disease (adjusted odds ratio, 1.60; 95% confidence interval, 1.16 to 2.21; adjusted odds ratio, 1.85; 95% confidence interval, 1.34 to 2.56, respectively) after simultaneously adjusting for other traditional and nontraditional risk factors.
Temporal association is unknown.
Periodontal disease and its severe consequence, edentulism, were independently associated with chronic kidney disease after adjusting for other traditional and nontraditional risk factors. This model could contribute to identifying individuals at risk of chronic kidney disease and reduce its burden.
慢性肾脏病在大量成年人中未被诊断出来，是一个公共卫生问题。鉴于对牙周病的全身炎症反应，我们推测牙周病可能与慢性肾脏病有关。
横断面研究。
在第三次全国健康与营养检查调查中，我们确定了12947名18岁及以上的成年人，他们有肾功能信息且至少有一个风险因素。
主要预测因素是牙周状况。其他非传统和传统风险因素包括社会经济状况、健康状况、健康行为、生物标志物水平、人体测量评估和医疗保健利用情况。
慢性肾脏病采用肾脏病预后质量倡议3期和4期定义，肾功能有中度至重度下降（肾小球滤过率为15至59毫升/分钟/1.73平方米）。单变量和多变量逻辑回归模型评估了慢性肾脏病与牙周病及其他非传统风险因素之间的关联。
慢性肾脏病患病率为3.6%；牙周病患病率为6.0%；无牙患病率为10.5%。在同时调整其他传统和非传统风险因素后，患有牙周病的成年人和无牙成年人患慢性肾脏病的可能性是正常人的两倍（调整后的优势比分别为1.60；95%置信区间为1.16至2.21；调整后的优势比为1.85；95%置信区间为1.34至2.56）。
时间关联尚不清楚。
在调整其他传统和非传统风险因素后，牙周病及其严重后果无牙与慢性肾脏病独立相关。该模型有助于识别慢性肾脏病风险个体并减轻其负担。
