Division of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Department of Periodontology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
BMC Nephrol. 2023 Mar 24;24(1):71. doi: 10.1186/s12882-023-03102-8.
The microinflammatory state can influence the occurrence of dialysis-related complications in dialysis patients. Chronic periodontitis (CP), in which plaque biofilm is considered to be the initiating factor, is a chronic infectious disease in the oral cavity. It is still uncertain whether CP affects the microinflammatory state in peritoneal dialysis (PD) and the occurrence of dialysis-related complications. The purpose of this study was to investigate the correlation between the periodontal index and clinical parameters in peritoneal dialysis patients with CP and dialysis-related complications, including peritoneal dialysis-associated peritonitis (PDAP) and cardiovascular and cerebrovascular events (CCEs).
This was a retrospective cohort study, and 76 patients undergoing PD were enrolled. Clinical parameters, the occurrence of PD-related complications and periodontitis-related indicators, including the gingival index (GI), plaque index (PLI), probing depth (PPD) and clinical attachment loss (CAL), were collected. Correlation analysis was used to explore the correlation between periodontal or clinical parameters and the occurrence of PD-related complications.
All the patients had different degrees of periodontitis (mild 9.2%, moderate 72.4%, severe 18.4%); PPD was inversely related to serum albumin (r = - 0.235, p = 0.041); CAL has a positive correlation with serum C-reactive protein (rs = 0.242, p = 0.035); PLI was positively correlated with serum calcium (r = 0.314, p = 0.006). ANOVA, multivariate logistic regression analysis and Kaplan-Meier Survival curve suggested that CAL was a risk factor for the occurrence of PDAP. There was no correlation between periodontal parameters and CCEs or poor prognosis.
CP is universally present in PD patients, and the presentation of periodontitis influences the systemic inflammatory state in PD patients. CP is a risk factor for PDAP.
微炎症状态可影响透析患者发生透析相关并发症。慢性牙周炎(CP)被认为是一种以菌斑生物膜为起始因素的慢性口腔传染病。目前尚不清楚 CP 是否会影响腹膜透析(PD)患者的微炎症状态以及与透析相关的并发症(包括腹膜透析相关性腹膜炎 [PDAP] 和心血管及脑血管事件 [CCEs])的发生。本研究旨在探讨 CP 及 PD 患者的牙周指数与临床参数之间的相关性,这些 CP 及 PD 患者发生了与 PD 相关的并发症,包括 PDAP 和 CCEs。
这是一项回顾性队列研究,共纳入 76 例行 PD 的患者。收集了临床参数、PD 相关并发症和牙周炎相关指标,包括牙龈指数(GI)、菌斑指数(PLI)、探诊深度(PPD)和临床附着丧失(CAL)。采用相关分析探讨牙周或临床参数与 PD 相关并发症发生的相关性。
所有患者均有不同程度的牙周炎(轻度 9.2%,中度 72.4%,重度 18.4%);PPD 与血清白蛋白呈负相关(r=-0.235,p=0.041);CAL 与血清 C 反应蛋白呈正相关(rs=0.242,p=0.035);PLI 与血清钙呈正相关(r=0.314,p=0.006)。方差分析、多因素 logistic 回归分析和 Kaplan-Meier 生存曲线表明,CAL 是 PDAP 发生的危险因素。牙周参数与 CCEs 或不良预后之间无相关性。
CP 在 PD 患者中普遍存在,牙周炎的发生影响 PD 患者的全身炎症状态。CP 是 PDAP 的危险因素。