UCSF

Purpose:

The aim of this study is to investigate, in a population of patients with compromised renal function, is there a correlation in periodontal status using systemic markers of estimated glomerular filtration rate (eGFR), HbA1C, and serum albumin to creatinine ratio.

Methods:

Patients’ were screened for kidney disease and had to have an eGFR <60 ml/min/m2. They were also screened for periodontal disease and had to have been diagnosed with moderate/severe periodontal disease according to CDC/AAP guidelines and have 30% BOP. After patients’ met inclusion/exclusion criteria, a thorough periodontal exam was performed at baseline which included: probing depths (PD), gingival margin position (GM), clinical attachment level (CAL), plaque index (PI), gingival index (GI), and bleeding on probing (BOP) at six sites (MB, B, DB, DL, L, and ML) per tooth for every tooth. Additionally, blood and urine samples were taken at baseline as well to measure eGFR, HbA1c, and serum albumin to creatinine ratio. Simple statistics such as means, medians, and standard deviations were calculated for the entire population for both periodontal and kidney parameters. Also spearman rank correlations were calculated to determine if there were any associations between periodontal disease and chronic kidney disease. Lastly, surrogate markers of periodontal disease such as PD and CAL were stratified into categories to determine if there was any correlation with chronic kidney disease.

Results:

After applying the inclusion and exclusion criteria, 21 subjects entered the study. For correlation between kidney markers and periodontal markers, the eGFR was moderately positively correlated with average CAL (r = 0.46956, p ≤ 0.0317), and HBA1C (%) was moderately negatively associated with average PI (r = 0.51205, p ≤ 0.0176). When stratifying the data into PD and CAL categories, there were some differences that could be seen amongst the surrogate markers for chronic kidney disease, but none were statistically significant. Additionally, there was no statistically significant correlation between BOP % and markers of kidney function assessed in this study such as eGFR, HbA1c, and serum albumin to creatinine ratio %.

Conclusions:

There was no evidence in this study that supported the hypothesis that the severity of periodontal disease is correlated to the severity of chronic kidney disease and vice versa. The results of this study need to be interpreted with caution due to the small population (n = 21). Therefore, larger scale studies with more subjects, which look at populations more representative of the population as a whole, need to be conducted to determine if there is a correlation between periodontal disease and chronic kidney disease (CKD). Also, longitudinal studies of this magnitude need to be carried out to see if improvements of markers of one disease affect markers of the other.