Importance of periodontal disease in the kidney patient.
End-stage renal disease (ESRD) patients on hemodialysis experience a greatly increased rate of atherosclerotic complications. In both hemodialysis and general populations, it has become evident that inflammation plays a central role in the pathogenesis of atherosclerotic complications. C-reactive protein (CRP), the major acute phase protein in man, has been found to predict all-cause and cardiovascular mortality in ESRD patients on hemodialysis maintenance therapy. Hepatic CRP synthesis is upregulated by proinflammatory cytokines released locally at sites of infection or inflammation, although many patients experience elevated CRP values in the absence of overt infection or inflammation. Destructive periodontal diseases in the general population have been associated with both an increased prevalence of atherosclerotic complications and an elevation in serum CRP values. In view of the prevalence of destructive periodontal diseases in the general population, and since periodontal evaluations are normally not performed as part of a medical assessment, destructive periodontal diseases may be an over looked source of inflammation in ESRD patients on hemodialysis therapy. The intent of this report is to review the possible role destructive periodontal diseases and associated periodontal infections may play in the management of the ESRD patient on hemodialysis maintenance therapy.
Craig
Robert G
RG
Department of Basic Science, New York University College of Dentistry, New York, NY 10010, USA. rgc1@nyu.edu
Spittle
Margaret A
MA
Levin
Nathan W
NW
D000210:Acute-Phase Reaction / Q000209:etiology; D001161:Arteriosclerosis / Q000209:etiology; D002097:C-Reactive Protein / Q000378:metabolism / Q000502:physiology; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications* / Q000628:therapy; D010510:Periodontal Diseases / Q000150:complications / Q000209:etiology* / Q000473:pathology; D006435:Renal Dialysis / Q000009:adverse effects
D002097:C-Reactive Protein