The Biochemical Effects of Non-surgical Periodontal Therapy in Patients with and without Chronic Renal Disease

Abstract

Recent studies have shown an association between high levels of biomarkers and periodontitis, association which decreases after the periodontal treatment. Because of this association with systemic inflammatory response, chronic periodontitis was recently included as a risk factor for chronic renale disease. Specifically, in this study we hypothesized that a part of chronic inflammatory response observed in patients with chronic renale disease is due to physiopathological reactions caused by the presence of chronic periodontitis, which, during the course of its evolution, induces an increase in the expression of inflammatory markers. Patients were divided into two groups: the first group consisted of patients with chronic renale disease and periodontal disease who were undergoing periodontal treatment (test group) and the second group, control group, composed of patients without any systemic disease, but who experienced moderate to severe chronic periodontitis, also periodontal treated. Blood samples were taken for biochemical analysis at baseline and at 3 months after periodontal therapy. Venous blood was collected in vacuum tubes between 7:00 am and 9:00 am after 12 hours after the last meal. A tube containing EDTA was analyzed for blood following parameters: albumin, uric acid, creatinin, urea. An association between periodontal disease and renale disease is often found in studies using a population where the renale disease is already diagnosed. In these cases, duration of renal end stage and type of topical and systemic treatment administered to patients significantly affect the association. Therefore, we have shown that periodontitis may promote any detectable changes in renal function. Thus, by analogy, in this study the test groups and control groups were compared not only with each other but also comparative analyzes were performed based on the reference values of markers of renal dysfunction. We think it could be plausible existence of a causal link between periodontal disease and chronic renal disease both by glomerular invasion by periodontal pathogens, directly and indirectly through systemic inflammatory effect caused by chronic periodontitis. Success of periodontal therapy reduce systemic inflammatory response and decreases levels of biochemicals markers indicating that this may be an important intervention therapy in patients with chronic renale disease.