Association between chronic kidney disease and periodontitis. A systematic review and metanalysis

Objectives Aims of this SR were to assess the association of Periodontitis (PD) with Chronic Kidney Disease (CKD) and with different CKD stages. Materials and methods MEDLINE, Cochrane Central Register of Trials and EMBASE, up to April 4, 2021 were searched. RCTs, prospective and retrospective cohort studies, case-control studies and cross-sectional studies were considered. JBI's Critical Appraisal Tool for risk of bias assessment was used. The risk of PD was calculated using the Mantel-Haenszel odds ratios (MH-OR); weighted mean difference for clinical attachment level (CAL) and periodontal probing depth (PPD) were also evaluated. Results Out of 1949 titles screened, 142 full texts were evaluated and 17 studies were included. CKD was associated to higher risk of PD (MH-OR = 2.36, [95% C.I. 1.25, 4.44]; p = 0.008), higher mean CAL (WMD = 0.41 mm [95% C.I. 0.22, 0.60]; p < 0.0001) and mean PPD (WMD = 0.25 mm [95% C.I. 0.03, 0.47]; p = 0.02) compared to healthy individuals. Severe CKD (stages 4-5 vs 2-3) resulted at higher risk of PD (MH-OR = 2.21, [95% C.I. 1.07, 4.54]; p = 0.03). Heterogeneity and risk of bias were high. Conclusions An association between PD and CKD was found. It could be appropriate to consider PD a frequent CKD comorbidity.

Automated summary

This systematic review assessed the association between periodontitis and chronic kidney disease (CKD) as well as different stages of CKD. The results showed that CKD patients had a higher risk of periodontitis compared to healthy individuals, and they also had higher clinical attachment levels and periodontal probing depths. Severe stages of CKD were associated with an increased risk of periodontitis. However, there were high levels of heterogeneity and bias in the included studies.