Severe periodontitis is associated with low serum albumin among patients on maintenance hemodialysis therapy.
The relationship between periodontitis and two measures of systemic inflammation, serum albumin and C-reactive protein (CRP), were examined among patients who were receiving chronic outpatient hemodialysis. Adult patients at two locations, North Carolina and New York City, were evaluated by dentist examiners. Six sites per tooth (up to 32 teeth per patient) were examined. A periodontitis case was defined as > or = 60% of sites with attachment level > or = 4 mm. Multivariable logistic regression was used to determine the association of periodontitis with low serum albumin, defined as < 3.5 mg/dl, and with high CRP, defined as > 3.0 mg/dl. A total of 154 patients completed the study. The mean age was 54.6 yr (SD 13.3), and average duration of dialysis was 4.0 yr (3 mo to 16 yr). Eighty-six (54.6%) were men, and 89 (58.2%) were black. Common causes of end-stage kidney disease were hypertension (12.3%), diabetes (22.1%), glomerulonephritis (7.1%), and other (58.4%). The average number of teeth was 20.3 (SD 8.4). Thirty-five (23%) patients were periodontitis cases. Severe periodontitis was associated with low serum albumin (odds ratio 8.20; 95% confidence interval 1.61 to 41.82; P = 0.01) compared with individuals without severe periodontitis disease after adjustment for age, gender, race, diabetes, hypertension, body mass index, smoking, study site, total cholesterol, serum calcium, serum phosphorus, and normalized protein catabolic rate. There was no observed association of severe periodontitis with CRP. Investigation of the potential contribution of periodontitis to serum albumin and possibly to morbidity and mortality among patients with end-stage kidney disease seems warranted.
Kshirsagar
Abhijit V
AV
Division of Nephrology and Hypertension, UNC Kidney Center, School of Medicine, Chapel Hill, NC 27599-7155, USA. sagar@med.unc.edu
Craig
Ronald G
RG
Beck
James D
JD
Moss
Kevin
K
Offenbacher
Steven
S
Kotanko
Peter
P
Yoshino
Maki
M
Levin
Nathan W
NW
Yip
Julie K
JK
Almas
Khalid
K
Lupovici
Eva
E
Falk
Ronald J
RJ
D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010518:Periodontitis / Q000097:blood*; D006435:Renal Dialysis; D012709:Serum Albumin / Q000032:analysis*; D012720:Severity of Illness Index
D012709:Serum Albumin