Abstract
ObjectivesTo compare the periodontal health related–inflammatory and metabolic differences between patients with end-stage renal disease (ESRD) and healthy controls (HC), and to identify potential biomarkers in gingival crevicular fluid (GCF) and serum of ESRD patients for predictive, preventive, and personalized medicine (PPPM).MethodsPatients with ESRD (ESRD group; n = 52) and healthy controls (HC group; n = 44) were recruited. Clinical periodontal parameters were recorded. The differential metabolites in the GCF and serum were identified by liquid chromatography/mass spectrometry (LC/MS). Inflammatory markers including interleukin-1β (IL-1β), interleukin-6 (IL-6), interleukin-8 (IL-8), and C-reactive protein (CRP) were also assessed.ResultsIn the ESRD group, IL-8 and CRP were significantly higher in GCF, whereas IL-6 and CRP were significantly higher in serum, compared with HC group (all P < 0.05). In the case of GCF, taurine levels were positively correlated with IL-8 levels in both groups (all P < 0.05). In the case of serum, l-phenylalanine and p-hydroxyphenylacetic acid levels were positively correlated with CRP levels in both groups (all P < 0.05). Significant positive correlations were observed between metabolites (including pseudouridine, l-phenylalanine, and p-hydroxyphenylacetic acid) and IL-6 levels only in ESRD group.ConclusionsIL-8 and CRP are potential inflammatory makers that reflect the periodontal health of ESRD individual, which may be considered the valuable predictive diagnostics in the agreement with PPPM philosophy. Besides, metabolites of taurine in GCF as well as l-phenylalanine and p-hydroxyphenylacetic acid in serum are possible biomarkers correlated with inflammatory markers. All these biomarkers may also be highly recommended as a novel predictive/diagnostic tool for the assessment of inflammatory status from the perspectives of PPPM in view of susceptible population and individual screening.
Highlights
End‐stage renal disease as the healthcare challengeEnd-stage renal disease (ESRD) refers to the end stage of chronic kidney disease (CKD) that requires renal replacement therapy, including peritoneal dialysis, hemodialysis, or kidney transplantation [1]
52 were endstage renal disease (ESRD) patients receiving hemodialysis treatment (30 males and 22 females; group designated as ESRD), and 44 were healthy controls (25 males and 19 females; group designated as HC)
Since the distributions of diabetes and hypertension history between ESRD and HC groups were significantly different, multiple factor AVOVA was performed to explore the association between groups (ESRD and HC groups), diabetes, hypertension history, and IL-8 levels in the gingival crevicular fluid (GCF)
Summary
End‐stage renal disease as the healthcare challenge. End-stage renal disease (ESRD) refers to the end stage of chronic kidney disease (CKD) that requires renal replacement therapy, including peritoneal dialysis, hemodialysis, or kidney transplantation [1]. ESRD patients with hemodialysis therapy have a relatively lower life expectancy than the general population, whose 5-year survival rate is estimated to be 76% [2]. Evidence from observational studies suggests that a larger proportion of patients undergoing dialysis treatment suffer from periodontal diseases [3]. It is reported that 58.9% of hemodialysis patients have moderate to severe periodontitis [4]. A number of studies have shown the association between periodontal health and ESRD [4,5,6,7]. End‐stage renal disease as a risk factor of periodontal health
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