Periodontal disease linked to kidney function decline in Hispanic, Latino patients
Specific markers of periodontal disease were associated with eGFR decline during a 6-year period, according to a study of Hispanic and Latino patients who underwent full dental examination at sites across the United States.
“In this large, prospective community-based cohort study of Hispanics/Latinos, we did not find consistent associations between periodontal disease and kidney disease outcomes. However, select periodontal measures (including >30% sites with probing depth 4 mm and absence of functional dentition) were associated with increased risk for incident low eGFR,” Stephanie M. Toth-Manikowski, MD, of the University of Illinois at Chicago, and colleagues wrote. “To our knowledge, this represents the first study in the U.S. to evaluate this association in a large and diverse cohort of Hispanics/Latinos.”
For the investigation, Toth-Manikowski and colleagues assessed data related to 7,732 participants in the Hispanic Community Health Study/Study of Latinos who did not have chronic kidney disease at baseline (mean age was 41.5 years; 45.2% were men).
All participants were required to complete a full periodontal examination, during which researchers noted the percentage of sites with clinical attachment loss of at least 3 mm, the percentage of sites with probing depth of at least 4 mm, the percentage of sites with bleeding on probing and functional dentition (considered absent if patients had less than 21 permanent teeth).
A follow-up visit assessing kidney function was conducted at a median of 5.9 years from baseline, wherein researchers considered incident low eGFR (defined as eGFR less than 60 mL/min/1.73 m2 and decline in eGFR at least 1 mL per min per year), incident albuminuria and the change in eGFR and albumin creatinine ratio.
Results of the dental exam showed that, of the entire study population, 11.7% had at least 30% of sites with clinical attachment loss of at least 3 mm, 5.1% had at least 30% of sites with probing depth of at least 4 mm, 30.7% had at least 50% of sites with bleeding on probing and 16.2% had absent functional dentition.
Periodontal disease severity (as assessed by the above markers) was associated with higher rates of incident low eGFR (mean change in eGFR was -0.39 mL/min/1.73 m2), with patients who had at least 30% of sites with probing depth of at least 4 mm or the absence of functional dentition at an increased risk (incident density ratios of 2.31 and 1.65, respectively).
No significant associations were observed between clinical attachment level status or percent of sites with bleeding on probing with incident low eGFR, nor was an association found between any of the measures and incident albuminuria. The results did not appear to be modified by age, sex or diabetes status, the researchers noted.
“Our findings are consistent with those from other studies, and may have potential public health significance for a population which experiences high rates kidney failure,” Toth-Manikowski and colleagues concluded. “Future work is needed to investigate the impact of treatment of periodontal disease on the prevention of CKD.”