Association between periodontal disease and systemic inflammation in patients on chronic hemodialysis

Previous studies have demonstrated that severe chronic periodontitis is associated with an increased risk of cardiovascular mortality in the hemodialysis population. However, the association between periodontal disease and systemic inflammation in these patients is not yet fully understood. C - reactive protein (CRP) is one of the plasma proteins that appear in the acute phase of inflammation. Periodontitis is associated with elevated levels of CRP in adults and with its decrease after treatment. The aim of this study was to evaluate the association between periodontal disease and systemic inflammation in patients on chronic hemodialysis (HD). An analytical cross-sectional study was carried out on 111 outpatients with end-stage renal disease (ESRD) on chronic HD. Periodontal disease was measured by periodontal pocket depth (PPD), loss of clinical attachment level (CAL), gingival index, and plaque index. Systemic inflammation was measured by high-sensitivity C-reactive protein (hs-CRP) levels. A multivariable linear regression model was created using hs-CRP as the dependent variable. Eighty-four patients with low hs-CRP levels (<= 1 mg/dL) and 27 patients with high hs-CRP levels (>1 mg/dL) were included. Patients with high hs-CRP were older, with diabetes, and with higher scores in oral health indexes. hs- CRP levels had a significant positive correlation with age, gingival index, PPD, and loss of clinical-attachment level. Finally, regression identified PPD and diabetes as independent hs-CRP contributors. In patients on chronic HD, PPD is an independent contributor of systemic inflammation.