Department of Periodontology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
Medical School, Lutheran University of Brazil, Canoas, Brazil.
Oral Dis. 2020 Mar;26(2):447-456. doi: 10.1111/odi.13236. Epub 2019 Dec 5.
The aim of this cross-sectional study was to evaluate the association between periodontitis and different severities of chronic kidney disease (CKD) in predialytic patients.
Demographic, socioeconomic, and medical data of 139 patients from the nephrology service of one university hospital in Porto Alegre, Brazil, were obtained through interview and clinical records. Full-mouth six-sites per tooth periodontal examinations were performed. Associations between periodontitis, stages of CKD, and estimated glomerular filtration rate (eGFR) were estimated by multivariable models adjusted for sex, smoking, vitamin D supplementation, physical activity, and renal treatment duration. CKD was classified based on eGFR (<60 ml/min/1.73 m ) estimated by the Chronic Kidney Disease Epidemiology Collaboration equation.
Patients with severe periodontitis, compared to those without severe periodontitis, had 2.8 (95% CI: 1.25-6.62) and 3.4 (95% CI: 1.27-9.09) times higher risk of being in stages 4 and 5 of CKD, respectively. Having ≥ 2 teeth with clinical attachment loss (CAL) ≥6 mm increased 3.9 times the risk of being in stage 5 of CKD. Patients with severe periodontitis and ≥2 teeth with CAL ≥ 6 mm had 4.4 ml/min/1.73 and 5.2 ml/min/1.73 lower eGFR (p-values < .05), respectively.
Severe periodontitis was associated with poor renal conditions in predialytic CKD patients, strengthening the importance of periodontal evaluation in such patient population.
本横断面研究旨在评估牙周炎与透析前慢性肾脏病（CKD）不同严重程度之间的关系。
通过访谈和临床记录，获取了巴西阿雷格里港一所大学医院肾病科 139 例患者的人口统计学、社会经济学和医学数据。对每位患者的每颗牙齿的 6 个部位进行全口牙周检查。通过多变量模型，调整性别、吸烟、维生素 D 补充、身体活动和肾脏治疗持续时间等因素，评估牙周炎与 CKD 分期和估计肾小球滤过率（eGFR）之间的相关性。根据慢性肾脏病流行病学合作组方程估计的 eGFR（<60 ml/min/1.73 m ），将 CKD 分为不同阶段。
与无重度牙周炎的患者相比，重度牙周炎患者发生 CKD 4 期和 5 期的风险分别高 2.8 倍（95%CI：1.25-6.62）和 3.4 倍（95%CI：1.27-9.09）。≥2 颗牙齿的临床附着丧失（CAL）≥6mm 使发生 CKD 5 期的风险增加 3.9 倍。重度牙周炎且≥2 颗 CAL≥6mm 的患者的 eGFR 分别低 4.4ml/min/1.73 和 5.2ml/min/1.73（p 值均<.05）。
重度牙周炎与透析前 CKD 患者的肾脏状况不良相关，这进一步强调了在该患者群体中进行牙周评估的重要性。
