Rajaratinam Harishini, Abdul Rahman Nurul Aliya, Hanafi Muhammad Hafiz, Zainuddin Siti Lailatul Akmar, Ibrahim Hanim Afzan, Kamarudin Muhammad Imran, Wan Zain Wan Mohd Saifuhisam, Kuttulebbai Nainamohamed Salam Sirajudeen, Isa Salbiah, Kassim Nur Karyatee
School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
PeerJ. 2025 May 29;13:e19492. doi: 10.7717/peerj.19492. eCollection 2025.
This comparative prospective cohort study investigated the outcomes of non-surgical periodontal therapy (NSPT) on periodontal parameters, renal function, and serum inflammatory markers in chronic kidney disease (CKD) patients with periodontitis.
Participants were categorised into three groups: CKD patients with periodontitis (CKD-P, = 20), patients with periodontitis only (P, = 20), and healthy participants (HP, = 20). Periodontal parameters were initially evaluated for all participants. Blood samples were collected to assess renal function, including serum electrolytes, urea, creatinine and estimated glomerular filtration rate (eGFR), as well as inflammatory markers such as interleukin-6 (IL-6) and transforming growth factor-beta 1 (TGF-β1). NSPT was performed on both the CKD-P and P groups. Six weeks following treatment, periodontal parameters, renal function tests and inflammatory markers were re-evaluated to determine any modulation in these outcomes.
The CKD-P group exhibited the highest concentration of potassium, urea, and creatinine. There were no significant differences in the periodontal pocket depth (PPD) and clinical attachment loss (CAL) means between CKD-P and P groups ( > 0.05). Similarly, there was no significant difference in the gingival bleeding index (GBI) scores between CKD-P, P, and HP groups ( > 0.05). However, the CKD-P group exhibited the highest plaque score (PS) compared to the P and HP groups ( < 0.0001). Post-NSPT, both the CKD-P and P groups showed significant improvement in these periodontal parameters. The median eGFR for the CKD-P group improved significantly ( < 0.0001) after NSPT. In terms of inflammatory markers, the IL-6 levels were significantly higher in the CKD-P group compared to the P and HP groups ( < 0.001). Additionally, there were significant differences in the TGF-β1 levels across all three groups ( < 0.05). Following post-NSPT, both CKD-P ( < 0.001) and P ( < 0.0001) groups demonstrated significant reductions in IL-6. As for the TGF-β1 level, significant reduction post-NSPT was only observed in the CKD-P group ( < 0.001).
NSPT is effective in enhancing periodontal health, improving renal function, and decreasing systemic inflammation in CKD patients with periodontitis.
这项比较性前瞻性队列研究调查了非手术牙周治疗（NSPT）对慢性肾脏病（CKD）合并牙周炎患者的牙周参数、肾功能和血清炎症标志物的影响。
参与者被分为三组：CKD合并牙周炎患者（CKD-P组，n = 20）、仅患有牙周炎的患者（P组，n = 20）和健康参与者（HP组，n = 20）。对所有参与者进行牙周参数的初始评估。采集血样以评估肾功能，包括血清电解质、尿素、肌酐和估计肾小球滤过率（eGFR），以及炎症标志物，如白细胞介素-6（IL-6）和转化生长因子-β1（TGF-β1）。对CKD-P组和P组均进行NSPT。治疗六周后，重新评估牙周参数、肾功能测试和炎症标志物，以确定这些结果是否有任何变化。
CKD-P组的钾、尿素和肌酐浓度最高。CKD-P组和P组之间的牙周袋深度（PPD）和临床附着丧失（CAL）平均值无显著差异（P > 0.05）。同样，CKD-P组、P组和HP组之间的牙龈出血指数（GBI）评分也无显著差异（P > 0.05）。然而，与P组和HP组相比，CKD-P组的菌斑评分（PS）最高（P < 0.0001）。NSPT后，CKD-P组和P组的这些牙周参数均有显著改善。CKD-P组的eGFR中位数在NSPT后显著改善（P < 0.0001）。在炎症标志物方面，CKD-P组的IL-6水平显著高于P组和HP组（P < 0.001）。此外，三组之间的TGF-β1水平存在显著差异（P < 0.05）。NSPT后，CKD-P组（P < 0.001）和P组（P < 0.0001）的IL-6均显著降低。至于TGF-β1水平，仅在CKD-P组观察到NSPT后显著降低（P < 0.001）。
NSPT可有效改善CKD合并牙周炎患者的牙周健康、肾功能并降低全身炎症反应。
