The impact of periodontal disease on physical and psychological domains in long-term hemodialysis patients: a cross-sectional study.

Abstract

Periodontal disease is a chronic infectious disease. Individuals with end-stage kidney disease (ESKD) experience impaired quality of life (QoL) and low oral health. This is the first comprehensive study which aimed to explore the link between periodontal disease and quality of life, assessed with the Short Form 36-Item Health Survey in hemodialysis patients. In total, 101 patients (57 females) with ESKD were recruited from two Romanian dialysis centers. Periodontal disease assessment included the measurement of periodontal disease index, with its three components: the gingival and periodontal index (GP), the bacterial plaque index (PI) and the calculus index (CI). For assessing QoL, we used the Short Form 36-Item Health Survey (SF-36), with its two components: physical component (PCS) and mental component (MCS). The mean age was 52.5±14.3years. The dialysis vintage was 6.7±5.6years. According to periodontal status, the mean value of GP was 4.0±1.3, mean PI was 1.8±0.9, and mean CI was 1.3±0.7. Regarding the QoL, the means for PCS and MCS were 38.0±17.3 and 45.0±16.3, respectively. In univariate analysis, the physical and mental components of QoL were significantly associated with the gingival and periodontal index, the bacterial plaque index and the calculus index. In the multivariable linear regression, only the gingival and periodontal index remained significantly associated with physical component (β=-3.26, p=0.04, 95% CI -6.39 to -0.13) and mental component (β=-5.57, p=0.001, 95% CI -8.74 to -2.41) of QoL. Our study shows a high prevalence and severity of periodontal disease. The gingival and periodontal index was associated with low QoL, both on physical and on mental components.