Abstract
IntroductionChronic kidney disease (CKD) is associated with periodontal disease due to its hyperinflammatory state. Limited studies have explored the prevalence of periodontal disease among CKD patients in Malaysia.ObjectiveTo assess the periodontal status of pre-dialysis CKD patients in Hospital Universiti Sains Malaysia.MethodsA total of 46 pre-dialysis CKD patients who attended the nephrology clinic at Hospital Universiti Sains Malaysia were enrolled in this study. Periodontal examination was performed using the periodontal probing depth (PPD), clinical attachment loss (CAL) and plaque index.ResultsThe majority of the CKD patients were Malay (95.7%) and 80.4% were males. The mean age of the patients was 58.5 years. Using PPD measurement, 37 (74.0%) of the patients had mild periodontitis, 9 (20.0%) had moderate periodontitis and 3 (6.0%) had no periodontitis. Based on CAL measurement, 12 (26%) patients had mild periodontitis, 29 (63.0%) had moderate periodontitis and 5 (11%) had severe periodontitis. The mean (standard deviation [SD]) value of mild and moderate-to-severe periodontitis by PPD measurement were 4.26 (0.26) and 5.24 (0.36), respectively. The mean of mild and moderate-to-severe periodontitis by CAL measurement were 2.66 (0.62) and 4.98 (0.73), respectively. There was no correlation between the periodontal parameters and estimated glomerular filtration rate (PPD: r = −0.160, P = 0.914; CAL: r = −0.135, P = 0.372; plaque index: r = 0.005, P = 0.974).ConclusionThis study revealed a greater prevalence and severity of chronic periodontitis among CKD patients. Thus, the periodontal health of CKD patients’ needs to be screened and monitored.
Highlights
Chronic kidney disease (CKD) is associated with periodontal disease due to its hyperinflammatory state
The clinical signs and symptoms of CKD are dependent on the stage of the disease; they affect most of the body systems and are collectively called uraemia [3]
CKD patients are known to be in a state of uraemia due to the limitation or reduction in the ability of the kidney to filter properly, which subsequently causes an increase in the level of toxic substances in the bloodstream
Summary
Chronic kidney disease (CKD) is associated with periodontal disease due to its hyperinflammatory state. Limited studies have explored the prevalence of periodontal disease among CKD patients in Malaysia. CKD patients are known to be in a state of uraemia due to the limitation or reduction in the ability of the kidney to filter properly, which subsequently causes an increase in the level of toxic substances in the bloodstream. This is accompanied by an altered immune system because of impaired T‐ and B-lymphocytes, as well as monocytes and macrophages [4], resulting in reduced host response to sub-gingival gram-negative microbial aggression. Uraemia might be associated with increased prevalence and severity of gingival inflammation and periodontitis, with increased dialysis vintage [4]
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