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Stages 3-5 chronic kidney disease: association between periodontitis and mortality


Periodontitis may add to the systemic inflammatory burden in individuals with chronic kidney disease ( CKD ), thereby contributing to an increased morality rate.
A study aimed to determine the association between periodontitis and mortality rate ( all-cause and cardiovascular disease- related ) in individuals with stage 3-5 chronic kidney disease.

Survival analysis was carried out using the Third National Health and Nutrition Examination Survey ( NHANES III ) and linked mortality data.
Cox proportional hazards regression was employed to assess the association between periodontitis and mortality, in individuals with chronic kidney disease. This association was compared with the association between mortality and traditional risk factors in CKD mortality ( diabetes, hypertension and smoking ).

Of the 13,784 participants eligible for analysis in NHANES III, 861 ( 6% ) had chronic kidney disease.

The median follow-up for this cohort was 14.3 years.

Adjusting for confounders, the 10 year all-cause mortality rate for individuals with chronic kidney disease increased from 32% ( 95% CI:29-35% ) to 41%( 36-47% ) with the addition of periodontitis.

For diabetes mellitus, the 10 year all-cause mortality rate increased to 43% ( 38-49% ).

In conclusion, there is a strong, association between periodontitis and increased mortality in individuals with chronic kidney disease.
Sources of chronic systemic inflammation ( including periodontitis ) may be important contributors to mortality in patients with chronic kidney disease. ( Xagena )

Sharma P et al, J Clin Periodontol 2015; Epub ahead of print

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