The Kidney and Periodontal Disease (KAPD) study: A pilot randomized controlled trial testing the effect of non-surgical periodontal therapy on chronic kidney disease

Contemp Clin Trials. 2017 Feb:53:143-150. doi: 10.1016/j.cct.2016.12.017. Epub 2016 Dec 20.

Abstract

Introduction: Chronic kidney disease (CKD) remains a prevalent public health problem that disproportionately affects minorities and the poor, despite intense efforts targeting traditional risk factors. Periodontal diseases are common bacterial plaque-induced inflammatory conditions that can respond to treatment and have been implicated as a CKD risk factor. However there is limited evidence that treatment of periodontal disease slows the progression of CKD.

Methods/design: We describe the protocol of the Kidney and Periodontal Disease (KAPD) study, a 12-month un-blinded, randomized, controlled pilot trial with two intent-to-treat treatment arms: 1. immediate intensive non-surgical periodontal treatment or 2. rescue treatment with delayed intensive treatment. The goals of this pilot study are to test the feasibility of conducting a larger trial in an ethnically and racially diverse, underserved population (mostly poor and/or low literacy) with both CKD and significant periodontal disease to determine the effect of intensive periodontal treatment on renal and inflammatory biomarkers over a 12-month period.

Results: To date, KAPD has identified 634 potentially eligible patients who were invited to in-person screening. Of the 83 (13.1%) of potentially eligible patients who attended in-person screening, 51 (61.4%) were eligible for participation and 46 enrolled in the study. The mean age of participants is 59.2years (range 34 to 73). Twenty of the participants (43.5%) are Black and 22 (47.8%) are Hispanic.

Discussion: Results from the KAPD study will provide needed preliminary evidence of the effectiveness of non-surgical periodontal treatment to slow CKD progression and inform the design future clinical research trials.

Keywords: (max 6) chronic kidney disease; Non-surgical periodontal disease treatment; Periodontal disease; Periodontitis, oral health.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Albuminuria / metabolism
  • Creatinine / metabolism
  • Disease Progression
  • Female
  • Humans
  • Lipocalin-2 / metabolism
  • Male
  • Middle Aged
  • Periodontal Diseases / complications
  • Periodontal Diseases / therapy
  • Periodontal Index
  • Periodontitis / complications
  • Periodontitis / therapy*
  • Pilot Projects
  • Renal Insufficiency, Chronic / complications
  • Renal Insufficiency, Chronic / metabolism*
  • Vulnerable Populations
  • Young Adult

Substances

  • LCN2 protein, human
  • Lipocalin-2
  • Creatinine