title: Periodontal disease adversely affects the survival of patients with end-stage renal disease.
abstract: Periodontal disease is associated with cardiovascular disease and is thought to accelerate systemic atherosclerosis. Here we examined the relationship between periodontitis and cardiovascular disease mortality in outpatients on hemodialysis using a retrospective analysis of 168 adult patients in New York City and North Carolina. During 18 months of follow-up, cardiovascular disease and all-cause mortality were determined from a centralized dialysis registry. One hundred patients had mild or no periodontal disease but the remaining 68 had moderate-to-severe disease defined as 2 or more teeth with at least 6 mm of inter-proximal attachment loss. At baseline, the proportion of males was significantly lower in the moderate-to-severe group. Compared with mild or no periodontal disease, moderate-to-severe disease was significantly associated with death from cardiovascular causes. Adjustment for age, gender, center and dialysis vintage, smoking status, and history of diabetes mellitus or hypertension did not diminish the strength of this association. Our findings suggest a need for larger studies to confirm this connection, along with intervention trials to determine if treating periodontitis reduces cardiovascular disease mortality in dialysis patients.
authors.affiliation: Division of Nephrology and Hypertension, Department of Medicine, UNC Kidney Center, School of Medicine, University of North Carolina at Chapel Hill, NC 27599-7155, USA. sagar@med.unc.edu
authors.forename: Abhijit V
authors.initials: AV
authors.lastname: Kshirsagar
authors.forename: Ronald G
authors.initials: RG
authors.lastname: Craig
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Moss
authors.forename: James D
authors.initials: JD
authors.lastname: Beck
authors.forename: Steven
authors.initials: S
authors.lastname: Offenbacher
authors.forename: Peter
authors.initials: P
authors.lastname: Kotanko
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Klemmer
authors.forename: Maki
authors.initials: M
authors.lastname: Yoshino
authors.forename: Nathan W
authors.initials: NW
authors.lastname: Levin
authors.forename: Julie K
authors.initials: JK
authors.lastname: Yip
authors.forename: Khalid
authors.initials: K
authors.lastname: Almas
authors.forename: Eva M
authors.initials: EM
authors.lastname: Lupovici
authors.forename: Len A
authors.initials: LA
authors.lastname: Usvyat
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Falk
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D009657:North Carolina / Q000453:epidemiology; D010510:Periodontal Diseases / Q000150:complications* / Q000401:mortality; D006435:Renal Dialysis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate