Sharma Praveen, Dietrich Thomas, Ferro Charles J, Cockwell Paul, Chapple Iain L C
Periodontal Research Group, School of Dentistry, University of Birmingham, Birmingham, UK.
Department of Nephrology, University Hospital Birmingham, Birmingham, UK.
J Clin Periodontol. 2016 Feb;43(2):104-13. doi: 10.1111/jcpe.12502. Epub 2016 Feb 18.
Periodontitis may add to the systemic inflammatory burden in individuals with chronic kidney disease (CKD), thereby contributing to an increased mortality rate. This study aimed to determine the association between periodontitis and mortality rate (all-cause and cardiovascular disease-related) in individuals with stage 3-5 CKD, hitherto referred to as "CKD".
Survival analysis was carried out using the Third National Health and Nutrition Examination Survey (NHANES III) and linked mortality data. Cox proportional hazards regression was employed to assess the association between periodontitis and mortality, in individuals with CKD. This association was compared with the association between mortality and traditional risk factors in CKD mortality (diabetes, hypertension and smoking).
Of the 13,784 participants eligible for analysis in NHANES III, 861 (6%) had CKD. The median follow-up for this cohort was 14.3 years. Adjusting for confounders, the 10-year all-cause mortality rate for individuals with CKD increased from 32% (95% CI: 29-35%) to 41% (36-47%) with the addition of periodontitis. For diabetes, the 10-year all-cause mortality rate increased to 43% (38-49%).
There is a strong, association between periodontitis and increased mortality in individuals with CKD. Sources of chronic systemic inflammation (including periodontitis) may be important contributors to mortality in patients with CKD.
牙周炎可能会增加慢性肾脏病（CKD）患者的全身炎症负担，从而导致死亡率上升。本研究旨在确定牙周炎与3-5期CKD患者（以下简称“CKD”）的死亡率（全因死亡率和心血管疾病相关死亡率）之间的关联。
使用第三次全国健康和营养检查调查（NHANES III）及相关死亡率数据进行生存分析。采用Cox比例风险回归评估CKD患者中牙周炎与死亡率之间的关联。并将这种关联与CKD死亡率的传统风险因素（糖尿病、高血压和吸烟）与死亡率之间的关联进行比较。
在NHANES III中符合分析条件的13784名参与者中，861人（6%）患有CKD。该队列的中位随访时间为14.3年。在对混杂因素进行调整后，患有CKD的个体中，加入牙周炎因素后，10年全因死亡率从32%（95%CI：29-35%）升至41%（36-47%）。对于糖尿病患者，10年全因死亡率升至43%（38-49%）。
CKD患者中，牙周炎与死亡率增加之间存在密切关联。慢性全身炎症的来源（包括牙周炎）可能是CKD患者死亡的重要因素。
