Periodontitis: Tip of the iceberg in chronic kidney disease

Abstract

The prevalence of chronic kidney disease (CKD) is constantly escalating not only in industrialized countries but throughout the world. It is of major significance because of to its high morbidity and mortality. Strategies to tackle this worldwide health problem include identification of its associated risk factors, comorbidities, and complications as well as proper management to handle all the pertinent issues. Periodontal disease, a treatable infectious state of the dental supporting tissues, is common in CKD patients. Its association with CKD is believed to be in a reciprocal or bidirectional fashion and has been massively studied. This paper, therefore, aims to review the recent evidence pertaining to the association between periodontal disease and a variety of renal illnesses. Most of the current evidence was collected from cross-sectional studies and clinical trials. There is substantial evidence indicating that periodontal disease contributes markedly to the chronic systemic inflammatory burden, leading to cardiovascular and cerebrovascular complications, the principal causes of death among chronic renal disease patients. Furthermore, several studies demonstrated that proper periodontal intervention could help improve systemic inflammation and even nutritional status among CKD patients, resulting in a better quality of life. Suggestions have been made that periodontal disease should be diagnosed early, and managed and controlled to, at least, eradicate a source of inflammation in this population. Awareness of such an important issue should be increased in the relevant medical personnel.

Keywords: Periodontitis; Chronic kidney disease; Dialysis; Kidney transplantation; Inflammation

Core tip: Periodontitis is gaining extensive public recognition due to its devastating impact on systemic diseases. Its association with chronic kidney disease is believed to be in a reciprocal or bidirectional fashion and has been extensively studied. In this review article, careful selection of involved studies was performed. This paper, thus, illustrates both the supporting and conflicting results of current publications pertaining to the association of periodontal disease and a variety of renal illnesses including glomerular diseases, and dialysis and kidney transplant populations.