Chronic periodontitis in hemodialysis patients with chronic kidney disease is associated with elevated serum C-reactive protein concentration and greater intima-media thickness of the carotid artery.
BACKGROUND
An increasing number of papers have documented the contribution of chronic periodontitis (P) to the pathogenesis of cardiovascular disease. The aim of this study was to answer the question whether there is an association between periodontal inflammation and atherosclerotic processes in hemodialysis patients with chronic kidney disease (CKD).


METHODS
Forty-four hemodialysis patients with CKD were considered. Advanced chronic periodontitis was found in 17, whereas 27 patients had no or moderate chronic periodontitis. In all patients examined, serum C-reactive protein (CRP), TNF-alfa and IL-6 concentrations, as well as intima-media thickness (IMT) of the carotid artery, were assessed.


RESULTS
Patients with CKD and advanced periodontitis were characterized by a significantly higher serum CRP concentration (13.2 +/- 11.4 vs. 10.4 +/- 14.4; p<0.05) and IMT (0.742 +/- 0.028 vs. 0.656 +/- 0.019, p<0.05) than CKD patients without periodontitis. In the univariate analysis, a significant correlation between CRP and number of atherosclerotic plaques was revealed; however, it was not confirmed as an independent relationship in the multiple regression analysis.


CONCLUSIONS
Inflammation of the periodontal tissue in patients with CKD is associated with increased serum CRP concentration and greater IMT. It is possible that periodontitis may induce a systemic process that may exacerbate atherosclerosis.
Franek
Edward
E
Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital MSWiA, Warsaw, Poland. Edward.Franek@cskmswia.pl
Blaschyk
Rafael
R
Kolonko
Aureliusz
A
Mazur-Psonka
Lidia
L
Łangowska-Adamczyk
Halina
H
Kokot
Franciszek
F
Wiecek
Andrzej
A
D000328:Adult; D002097:C-Reactive Protein / Q000378:metabolism*; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010518:Periodontitis / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging*; D006435:Renal Dialysis; D017539:Tunica Intima / Q000000981:diagnostic imaging; D017540:Tunica Media / Q000000981:diagnostic imaging; D014463:Ultrasonography
D002097:C-Reactive Protein