Prevalence of chronic periodontitis in patients undergoing peritoneal dialysis and its correlation with peritoneal dialysis-related complications

Zhihao Chen; Hai Deng; Kristine Sun; Zehui Huang; Shan Wei; Yunyao Lin; Zhongchen Song; Yingli Liu

doi:10.1186/s12882-023-03102-8

Prevalence of chronic periodontitis in patients undergoing peritoneal dialysis and its correlation with peritoneal dialysis-related complications

BMC Nephrol. 2023 Mar 24;24(1):71. doi: 10.1186/s12882-023-03102-8.

Authors

Zhihao Chen^#¹, Hai Deng^#¹, Kristine Sun^{2

3}, Zehui Huang¹, Shan Wei¹, Yunyao Lin¹, Zhongchen Song^{2

3}, Yingli Liu⁴

Affiliations

¹ Division of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
² Department of Periodontology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
³ National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China.
⁴ Division of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. liuyingli@sjtu.edu.cn.

^# Contributed equally.

Abstract

Objective: 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).

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: Cardiovascular disease; Periodontitis; Peritoneal dialysis; Peritonitis.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Chronic Periodontitis* / complications
Chronic Periodontitis* / epidemiology
Humans
Kidney Failure, Chronic* / epidemiology
Kidney Failure, Chronic* / therapy
Peritoneal Dialysis* / adverse effects
Prevalence
Renal Dialysis
Retrospective Studies