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Periodontal disease, chronic kidney disease and mortality: results from the third National Health and Nutrition Examination Survey.

Abstract：

BACKGROUND:Periodontal disease is associated with increased mortality in the general population, however its prognostic significance in chronic kidney disease (CKD) is not known. We evaluated the joint effect of periodontal disease and CKD on all-cause and cardiovascular mortality. METHODS:Prospective observational study of 10,755 adult participants in the National Health and Nutrition Examination Survey, 1988-1994 (NHANES III). CKD was defined as estimated glomerular filtration rate < 60 ml/minute/1.73 m(2) or albumin-to-creatinine ratio ≥ 30 mg/g. Periodontal disease was defined as moderate (> 4 mm attachment loss in ≥ 2 mesial sites or 5 mm pocket depth in ≥ 2 mesial sites), or severe (> 6 mm attachment loss in ≥ 2 mesial sites and > 5 mm pocket depth in ≥ 1 mesial site). All-cause and cardiovascular mortality were evaluated using Cox proportional hazards models. RESULTS:There were 1,813 deaths over a median follow-up of 14 years. In multivariate analyses, as compared to participants with neither periodontal disease nor CKD, those with periodontal disease only or CKD only had increased all-cause mortality (HR 1.39; 95 % CI, 1.06-1.81 and 1.55; 1.30-1.84, respectively). The presence of both periodontal disease and CKD was associated with HR (95 % CI) 2.07 (1.65-2.59) for all-cause mortality, and 2.11 (1.52-2.94) for cardiovascular mortality. We found no evidence of multiplicativity or additivity between periodontal disease and CKD. In stratified analyses limited to individuals with CKD, periodontal disease (vs. not) was associated with adjusted HR (95 % CI) 1.35 (1.04-1.76) for all-cause, and 1.36 (0.95-1.95) for cardiovascular mortality. CONCLUSIONS:These findings confirm the well-established association between periodontal disease and increased mortality in the general population, and provide new evidence of this association among individuals with CKD.

journal_name

BMC Nephrol

journal_title

BMC nephrology

authors

Ricardo AC,Athavale A,Chen J,Hampole H,Garside D,Marucha P,Lash JP

doi

10.1186/s12882-015-0101-x

subject

Has Abstract

pub_date

2015-07-07 00:00:00

pages

issn

1471-2369

pii

10.1186/s12882-015-0101-x

journal_volume

pub_type

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Periodontal disease, chronic kidney disease and mortality: results from the third National Health and Nutrition Examination Survey.