Correlation Between Periodontal Disease and Chronic Kidney Disease

Current clinical data suggests a bidirectional correlation between periodontal disease(PD) and chronic kidney disease (CKD), according to findings from an umbrella review recently published in the Journal of Periodontal Research.

The authors wrote, “Many systematic reviews and meta-analyses have demonstrated a strong relationship between CKD and periodontitis, where periodontal treatment has shown potential in improving CKD outcomes. However, the quality of the studies and heterogeneity of the results show variation.”

For this publication, the authors conducted an umbrella review and sought to assess the quality of the current systematic reviews regarding the association between CKD and oral health with a focus on periodontal disease. The authors also aimed to create clinically appropriate guidelines to foster and support periodontal health in patients with CKD.

The authors indicated that this umbrella review was managed and reported in association with the Joanna Briggs Institute and the PRISMA 2020 guidelines, and all systematic reviews and meta-analyses that explored the correlation between periodontitis or periodontal treatment and CKD were included.

The researchers found 371 studies, of which 18 systematic reviews met their inclusion criteria for this review. Of the 18 studies, 10 evaluated the association between oral health status and CKD, focusing on periodontitis and CKD. Five reviewed the impact of periodontal treatment on CKD outcomes, including non-surgical periodontal treatment (NSPT). Two studies examined the correlation and efficacy of periodontal treatment, and one study qualitatively evaluated the oral health-related quality of life in patients with kidney failure.

The authors noted that results from this review consistently indicated a statistically noteworthy greater probability of CKD in patients with periodontitis. The authors also indicated that healthcare providers should be mindful of the correlation between CKD and periodontitis, the increased risk of poorer outcomes among individuals with CKD who also have periodontal disease, and make recommendations for appropriate management tailored to patient needs.

Based on their findings, the authors concluded, “Current evidence, including evidence generated by this review, suggests a bi-directional relationship exists between periodontitis and CKD. NSPT is an effective way of treating periodontal disease, and evidence suggests it may reduce systemic inflammatory burden and, hence, improve renal function. If treatment of periodontal disease results in improved CKD, this would be a cost-effective and relatively non-invasive procedure with significant health benefits.”

Lastly, the authors noted that to validate the value of periodontal treatment on CKD outcomes, more well-constructed and long-term trials are warranted to better understand this issue.

Reference:

He I, Poirier B, Jensen E, Kaur S, Hedges J, Jesudason S, Jamieson L, Sethi S. Demystifying the connection between periodontal disease and chronic kidney disease - An umbrella review. J Periodontal Res. 2023 Oct;58(5):874-892. doi: 10.1111/jre.13161