Department of Dental Propaedeutics and Esthetics, Faculty of Dentistry, "Iuliu Hațieganu" University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania.
Department of Nephrology, "Iuliu Hațieganu" University of Medicine and Pharmacy, 2 Babes Street, 400012 Cluj-Napoca, Romania.
Int J Environ Res Public Health. 2023 Jan 11;20(2):1298. doi: 10.3390/ijerph20021298.
Periodontitis (PO), a chronic microbially-induced inflammation of the supporting tissues of the tooth, is linked to various systemic diseases. We analyze its bidirectional relationship to chronic kidney disease (CKD), a major health-care problem with impressive excess mortality. Overwhelming associative relationship between CKD and PO are analyzed. Major pathophysiologic mechanisms that link CKD to PO are then presented: systemic inflammation, endothelial dysfunction, and imbalance of oxidative stress characteristic of CKD have a role in PO development and might influence escape mechanisms of oral microbiota. Subclinical local and systemic inflammation induced by PO might influence in turn CKD outcomes. Homeostatic changes induced by CKD such as mineral bone disorders, acidosis, uremic milieu, or poor salivary flow are also relevant for the occurrence of PO. There is insufficient evidence to recommend a standardized diagnostic and therapeutic approach regarding association of PO to CKD.
牙周炎（PO）是一种慢性的、由微生物引起的牙齿支持组织炎症，与各种系统性疾病有关。我们分析了它与慢性肾脏病（CKD）的双向关系，CKD 是一个主要的医疗保健问题，其死亡率令人印象深刻。分析了 CKD 和 PO 之间压倒性的关联关系。然后提出了将 CKD 与 PO 联系起来的主要病理生理机制：CKD 的系统性炎症、内皮功能障碍和氧化应激失衡在 PO 的发展中起作用，并可能影响口腔微生物群的逃避机制。PO 引起的亚临床局部和全身炎症反过来可能影响 CKD 的结果。CKD 引起的内稳态变化，如矿物质骨骼紊乱、酸中毒、尿毒症环境或唾液流量减少，也与 PO 的发生有关。关于 PO 与 CKD 的关联，没有足够的证据推荐标准化的诊断和治疗方法。
