Association of Apical Periodontitis with Different Stages of Chronic Kidney Disease Measured by Glomerular Filtration Rate and Systemic Markers: An Observational Study

Abstract

IntroductionThe aim of this study was to assess the prevalence and severity of apical periodontitis (AP) in subjects with different stages of chronic kidney disease (CKD) and its association with systemic markers. MethodsIn this cross-sectional study, 105 patients with CKD (n = 35 each in the early, predialysis, and hemodialysis groups) and 105 healthy controls were included. The prevalence, number of teeth with AP (endodontic burden [EB]), and the severity of AP were recorded. High- sensitivity C-reactive protein, blood urea, and serum creatinine levels were also recorded. Logistic regression was applied to determine the possible association between CKD and AP in the study population, and linear regression was performed to predict the effect of AP on systemic markers in CKD patients. ResultsAP in at least 1 tooth was found in 75.2% of CKD patients and 40.9% of the controls (P < .05). CKD patients were 4 times more likely to have AP than controls (P < .05; odds ratio = 3.954; 95% confidence interval, 2.09–7.45). EB and the severity of AP were also significantly higher in CKD patients than the healthy controls (P < .05). Although higher values of EB and severe AP were observed with the progression of disease, the difference was not significant. The severity of AP was significantly associated with an increase in serum creatinine, blood urea, and a decrease in estimated glomerular filtration rate (P < .05) in CKD patients. ConclusionsAP was significantly more prevalent in the CKD group. The association between the severity of AP and CKD markers suggests that AP could possibly alter the progression of CKD. However, these findings do not establish a cause-and-effect relationship.