Effect of periodontal treatment on some serum biochemistry of patients with end-stage-kidney disease (A pilot study)

Hadeel Mohammed Abbood, Suha Aswad Dahash

Abstract


Background: Periodontal diseases are inflammatory diseases that affect the supporting structures of the teeth which could lead to tooth loss and contribute to systemic inflammation. End stage kidney disease (ESKD) is an established kidney failure which requires dialysis or a kidney transplant. Several studies have investigated the relationship between kidney diseases and periodontal disease. Objectives: This study aimed to investigate the effect of nonsurgical periodontal treatment on the serum chemistry of patients with ESKD. Methods: A randomized control trial was designed. Patients with periodontitis and ESKD were divided into two groups: the test group received nonsurgical periodontal treatment just prior to the hemodialysis appointment. The control group did not receive any periodontal treatment except oral hygiene instructions. Clinical periodontal parameters for all participants were recorded at baseline and one month follow-up. Serum albumin, creatinine, urea, total protein, alkaline phosphatase, phosphorus, and calcium levels were measured at baseline and one month follow-up too. Descriptive analysis in addition to t-test and univariate analysis were conducted. Results: This study showed no statistically significant change in any serum biochemistry measured between the two groups. Conclusion: Nonsurgical periodontal treatment does not have any effect on the studied serum biochemistry of patients with ESKD. However, ESKD patients suffer from moderate to severe periodontitis.

Clinical implication: we suggest a collaboration between periodontists and medical doctors to manage patients with chronic diseases. This will increase the patients’ quality of life and may improve the prognosis of the systemic disease.

Keywords: Periodontitis, periodontal treatment, end stage kidney disease.


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References


Papapanou P, Sanz M, Buduneli N, Dietrich T, Feres M, Fine DH, Flemmig T, Garcia R, Giannobile WV, Graziani F, Greenwell H, Herrera D, Kao RT, Kebschull M, Kinane D, Kirkwood K, Kocher T, Kornman K, Kumar P, Loos B, Machtei E, Meng H, Mombelli A, Needleman I, Offenbacher S, Seymour G, Teles R, Tonetti M. Periodontitis: Consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Clin Periodontol. 2018 Jun;45:S162–70.

Trindade D, Carvalho R, Machado V, Chambrone L, Mendes JJ, Botelho J. Prevalence of periodontitis in dentate people between 2011 and 2020: A systematic review and meta‐analysis of epidemiological studies. J Clin Periodontol. 2023 May 20;50(5):604–26.

Shi B, Chang M, Martin J, Mitreva M, Lux R, Klokkevold P, Sodergren E, Weinstock GM, Haake SK, Li H. Dynamic Changes in the Subgingival Microbiome and Their Potential for Diagnosis and Prognosis of Periodontitis. mBio. 2015 Feb 27;6(1).

Hajishengallis G, Darveau RP, Curtis MA. The keystone-pathogen hypothesis. Nat Rev Microbiol. 2012 Oct 3;10(10):717–25.

Lamont RJ, Hajishengallis G. Polymicrobial synergy and dysbiosis in inflammatory disease. Trends Mol Med. 2015 Mar;21(3):172–83.

Seymour GJ, Gemmell E. Cytokines in periodontal disease: where to from here? Acta Odontol Scand. 2001 Jan 2;59(3):167–73.

Gimbrone MA, García-Cardeña G. Endothelial Cell Dysfunction and the Pathobiology of Atherosclerosis. Circ Res. 2016 Feb 19;118(4):620–36.

Kwon T, Lamster IB, Levin L. Current Concepts in the Management of Periodontitis. Int Dent J. 2021 Dec;71(6):462–76.

Bui FQ, Almeida-da-Silva CLC, Huynh B, Trinh A, Liu J, Woodward J, Asadi H, Ojcius DM. Association between periodontal pathogens and systemic disease. Biomed J. 2019 Feb;42(1):27–35.

Taylor GW. Bidirectional Interrelationships Between Diabetes and Periodontal Diseases: An Epidemiologic Perspective. Ann Periodontol. 2001 Dec;6(1):99–112.

Stevens PE. Evaluation and Management of Chronic Kidney Disease: Synopsis of the Kidney Disease: Improving Global Outcomes 2012 Clinical Practice Guideline. Ann Intern Med. 2013 Jun 4;158(11):825.

Sanz M, Marco del Castillo A, Jepsen S, Gonzalez‐Juanatey JR, D’Aiuto F, Bouchard P, Chapple I, Dietrich T, Gotsman I, Graziani F, Herrera D, Loos B, Madianos P, Michel JB, Perel P, Pieske B, Shapira L, Shechter M, Tonetti M, Vlachopoulos C, Wimmer G. Periodontitis and cardiovascular diseases: Consensus report. J Clin Periodontol. 2020 Mar 3;47(3):268–88.

Costantinides F, Castronovo G, Vettori E, Frattini C, Artero ML, Bevilacqua L, Berton F, Nicolin V, Di Lenarda R. Dental Care for Patients with End-Stage Jun;89:S1–8

Löe H. The Gingival Index, the Plaque Index and the Retention Index Systems. J Periodontol. 1967 Nov;38(6):610–6.

Pihlstrom BL. Measurement of Attachment Level in Clinical Trials: Probing Methods. J Periodontol. 1992 Dec;63(12s):1072–7.

Mühlemann HR, Son S. Gingival sulcus bleeding- a leading symptom in initial gingivitis. Helv Odontol Acta. 1971 Oct;15(2):107–13.

Miyata Y, Obata Y, Mochizuki Y, Kitamura M, Mitsunari K, Matsuo T, Ohba K, Mukae H, Nishino T, Yoshimura A, Sakai H. Periodontal Disease in Patients Receiving Dialysis. Int J Mol Sci. 2019 Aug 3;20(15):3805.

Isakova T, Nickolas TL, Denburg M, Yarlagadda S, Weiner DE, Gutiérrez OM, Bansal V, Rosas SE, Nigwekar S, Yee J, Kramer H. KDOQI US Commentary on the 2017 KDIGO Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease–Mineral and Bone Disorder (CKD-MBD). Am J Kidney Dis. 2017 Dec;70(6):737–51.

Chung WC, Kao CC, Huang CF, Lee CY, Lu HK, Wu MS. Effects of Periodontal Treatment in Patients with Periodontitis and Kidney Failure: A Pilot Study. Int J Environ Res Public Health. 2022 Jan 29;19(3):1533.

Fang F, Wu B, Qu Q, Gao J, Yan W, Huang X, Ma D, Yue J, Chen T, Liu F, Liu Y. The clinical response and systemic effects of non-surgical periodontal therapy in end-stage renal disease patients: a 6-month randomized controlled clinical trial. J Clin Periodontol. 2015 Jun;42(6):537–46.

Kaur N, Kaur N, Sarangal V. A study to evaluate the correlation of serum albumin levels with chronic periodontitis. Indian J Dent Res. 2015;26(1):11.

Ashtankar M, Dixit M, Pimpale S. Evaluation of serum albumin concentration in generalized chronic periodontitis patients after surgical periodontal therapy. Indian J Multidisp Dent. 2019;9(2):77.

Don BR, Kaysen G. Poor nutritional status and inflammation: Serum Albumin: Relationship to Inflammation and Nutrition. Semin Dial. 2004 Dec 9;17(6):432–7.

Koot BartGP, Houwen R, Pot DJ, Nauta J. Congenital analbuminaemia: biochemical and clinical implications. A case report and literature review. Eur J Pediatr. 2004;1163(11):664-670

Foley RN, Parfrey PS, Harnett JD, Kent GM, Murray DC, Barre PE. Hypoalbuminemia, cardiac morbidity, and mortality in end-stage renal disease. J Am Soc Nephrol. 1996 May;7(5):728–36.

Mehrotra R, Duong U, Jiwakanon S, Kovesdy CP, Moran J, Kopple JD, Kalantar-Zadeh K. Serum Albumin as a Predictor of Mortality in Peritoneal Dialysis: Comparisons With Hemodialysis. Am J Kidney Dis. 2011 Sep;58(3):418–28.

Perrone RD, Madias NE, Levey AS. Serum creatinine as an index of renal function: new insights into old concepts. Clin Chem. 1992 Oct;38(10):1933–53.

Naghsh N, Sabet NK, Vahidi F, Mogharehabed A, Yaghini J. Relationship Between Periodontal Disease and Serum Factors in Patients Undergoing Hemodialysis. Open Dent J. 2017 Dec 29;11(1):701–9.

Savica V, Santoro D, Mazzaglia G, Ciolino F, Monardo P, Calvani M, Bellinghieri G, Kopple JD. L-carnitine infusions may suppress serum C-reactive protein and improve nutritional status in maintenance hemodialysis patients. J Ren Nutr. 2005 Apr 1;15(2):225–30.

Guzeldemir E, Toygar HU, Tasdelen B, Torun D. Oral health-related quality of life and periodontal health status in patients undergoing hemodialysis. J Am Dent Assoc. 2009;140(10):1283–93.




DOI: http://dx.doi.org/10.46466/idj.v46i1.285

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