Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan.
Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan.
Int J Environ Res Public Health. 2021 Aug 24;18(17):8910. doi: 10.3390/ijerph18178910.
Periodontitis is prevalent in patients with chronic kidney disease (CKD) and is also associated with kidney function decline. It is unclear whether dental scaling treatment prevents the progression of CKD. In a nationwide cohort study, Taiwan's National Health Insurance Research Database was used to select people with CKD. Propensity score-matching procedures were performed to compare the long-term risk of end-stage renal disease (ESRD) between CKD patients with and without the receipt of dental scaling. A total of 33,637 matched pairs with CKD were included, with 503,373 person-years of follow-up for analyses. Dental scaling was significantly associated with a lower risk of ESRD (adjusted hazard ratio (aHR): 0.83, 95% confidence interval (CI): 0.77-0.90). In addition, there was a dose-dependent relationship between the frequency of dental scaling and a reduced risk of ESRD. Dental scaling was also linked to reduced risks of major adverse cardiovascular events (aHR: 0.91, 95% CI: 0.87-0.95), sepsis (aHR: 0.81, 95% CI: 0.77-0.85), and all-cause mortality (aHR: 0.81, 95% CI: 0.76-0.87). Dental scaling was significantly associated with lower risks of progression to ESRD in patients with CKD. Regular dental scaling may serve as a prophylactic measure for kidney function decline.
牙周炎在慢性肾脏病（CKD）患者中较为普遍，且与肾功能下降相关。目前尚不清楚洁牙治疗是否能预防 CKD 的进展。本全国性队列研究利用台湾全民健康保险研究数据库选择 CKD 患者。通过倾向评分匹配程序比较了接受和未接受洁牙治疗的 CKD 患者发生终末期肾病（ESRD）的长期风险。共纳入 33637 对匹配的 CKD 患者，分析时共随访 503373 人年。洁牙与 ESRD 风险降低显著相关（调整后的危险比[aHR]：0.83，95%置信区间[CI]：0.77-0.90）。此外，洁牙频率与 ESRD 风险降低呈剂量依赖性关系。洁牙还与主要不良心血管事件（aHR：0.91，95% CI：0.87-0.95）、脓毒症（aHR：0.81，95% CI：0.77-0.85）和全因死亡率（aHR：0.81，95% CI：0.76-0.87）降低相关。在 CKD 患者中，洁牙与 ESRD 进展风险降低显著相关。定期洁牙可能是预防肾功能下降的一项措施。
