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Abstract
Introduction
Periodontitis may add to the systemic inflammatory burden in individuals with chronic kidney disease (CKD), thereby contributing to an increased morality rate. This study aimed to determine the association between periodontitis and mortality rate (all-cause and cardiovascular disease- related) in individuals with stage 3-5 CKD, hitherto referred to as “CKD”.
Methods
Survival analysis was carried out using the Third National Health and Nutrition Examination Survey (NHANES III) and linked mortality data. Cox proportional hazards regression was employed to assess the association between periodontitis and mortality, in individuals with CKD. This association was compared with the association between mortality and traditional risk factors in CKD mortality (diabetes, hypertension and smoking).
Results
Of the 13,784 participants eligible for analysis in NHANES III, 861 (6%) had CKD. The median follow-up for this cohort was 14.3 years.
Adjusting for confounders, the 10 year all-cause mortality rate for individuals with CKD increased from 32%(95%CI:29-35%) to 41%(36-47%) with the addition of periodontitis. For diabetes, the 10 year all-cause mortality rate increased to 43%(38-49%).
Conclusion
There is a strong, association between periodontitis and increased mortality in individuals with CKD. Sources of chronic systemic inflammation (including periodontitis) may be important contributors to mortality in patients with CKD.
Periodontitis may add to the systemic inflammatory burden in individuals with chronic kidney disease (CKD), thereby contributing to an increased morality rate. This study aimed to determine the association between periodontitis and mortality rate (all-cause and cardiovascular disease- related) in individuals with stage 3-5 CKD, hitherto referred to as “CKD”.
Methods
Survival analysis was carried out using the Third National Health and Nutrition Examination Survey (NHANES III) and linked mortality data. Cox proportional hazards regression was employed to assess the association between periodontitis and mortality, in individuals with CKD. This association was compared with the association between mortality and traditional risk factors in CKD mortality (diabetes, hypertension and smoking).
Results
Of the 13,784 participants eligible for analysis in NHANES III, 861 (6%) had CKD. The median follow-up for this cohort was 14.3 years.
Adjusting for confounders, the 10 year all-cause mortality rate for individuals with CKD increased from 32%(95%CI:29-35%) to 41%(36-47%) with the addition of periodontitis. For diabetes, the 10 year all-cause mortality rate increased to 43%(38-49%).
Conclusion
There is a strong, association between periodontitis and increased mortality in individuals with CKD. Sources of chronic systemic inflammation (including periodontitis) may be important contributors to mortality in patients with CKD.
| Original language | English |
|---|---|
| Journal | Journal of Clinical Periodontology |
| Early online date | 31 Dec 2015 |
| DOIs | |
| Publication status | E-pub ahead of print - 31 Dec 2015 |
Keywords
- Periodontitis
- Chronic Kidney Disease
- Survival
- NHANES
Access to Document
- Sharma_et_al_Association_between_Periodontitis_mortality_Journal_Clinical_Peridontology_Post-Print
This is the peer reviewed version of the following article: Sharma, Praveen, et al. "Association between Periodontitis and mortality in stages 3‐5 Chronic Kidney Disease: NHANES III and linked mortality study." Journal of clinical periodontology (2015)., which has been published in final form at http://dx.doi.org/10.1111/jcpe.12502. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. Checked Jan 2016
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Dive into the research topics of 'Association between Periodontitis and mortality in stages 3-5 Chronic Kidney Disease: NHANES III and linked mortality study'. Together they form a unique fingerprint.Projects
- 1 Finished
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Impact of Successful Periodontal Intervention on Renal and Vascular Systems in Patients with Chronic Kidney Disease - A Pilot Interventional Randomised Controlled Trial
Sharma, P., Chapple, I., Dietrich, T. & Rowland, N.
NIHR TRAINEES COORDINATING CENTRE
1/04/15 → 31/03/18
Project: Other Government Departments