Association between dental and periodontal conditions with chronic kidney disease: A cross-sectional analysis of urban South Africans

Cindy George,Gloudina M Hon,Rajiv T Erasmus,Saarah Fg Davids,Andre P Kengne,U Chikte,Tandi E Matsha

doi:10.17159/2519-0105/2022/v77no1a1

Abstract

Oral diseases are preventable causes of poor health outcomes in people with chronic kidney disease (CKD). Investigate the association between dental and periodontal conditions with kidney function and determine whether inflammation mediate the association between periodontitis and CKD. Cross-sectional analysis of 1551 South African adults of mixed ancestry. CKD was classified as estimated glomerular filtration rate (eGFR) <60mL/min/1.73m2. Oral profile was captured by decayed, missing, filled teeth index (DMFTi), bleeding on probing (BOP), pocket depth (PD), clinical attachment loss (CAL), and periodontitis classified as PD ≥4 mm.Overall, 6% had CKD, with 93% and 66% of participants with and without CKD, respectively having a high DMFTi (p<0.0001). Further, 84% (CKD) and 43% (without CKD) were edentulous (p<0.0001). A great proportion of the dentate sub-sample (n=846) had periodontitis, however, BOP, PD ≥4mm and CAL ≥4mm were similar between the groups. DMFTi was associated with eGFR and prevalent CKD (p<0.023), with this association driven by the Missing component. Periodontitis was not associated with eGFR nor CKD (p>0.282). In routine care of people with CKD, attention should be given to oral health.

Highlights

Oral diseases are preventable causes of poor health outcomes in people with chronic kidney disease (CKD)
A great proportion of the dentate sub-sample (n=846) had periodontitis, bleeding on probing (BOP), pocket depth (PD) ≥4mm and clinical attachment loss (CAL) ≥4mm were similar between the groups
DMFTi was associated with estimated glomerular filtration rate (eGFR) and prevalent CKD (p

Summary

Introduction

Oral diseases are preventable causes of poor health outcomes in people with chronic kidney disease (CKD). Chronic kidney disease (CKD) is a major public health problem,[1] estimated to affect at least 10% of the global adult population.[2]. Oral diseases are estimated to affect nearly half the global population.[4,5]. Of these oral diseases, periodontitis and dental caries have been implicated as a potential and preventable cause of poor health outcomes in people with CKD.[6-9]. Dental caries, characterized by the localized destruction of the teeth due to the accumulation of acidic by-products,[10] is much less 4 > RESEARCH www.sada.co.za / SADJ Vol 77 No 1 explored in the context of CKD. There is no consensus in the literature on dental caries prevalence and the association with CKD. Some studies have shown that patients with CKD presents with lower dental caries,[18,19] where others show that CKD is associated with a worse dental status[20] compared to those without CKD, with a few studies showing no association between dental complications and CKD.[21, 22]

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Conclusion