title: Periodontitis case definition affects the association with renal function in kidney transplant recipients.
abstract: OBJECTIVE
  The aim of this analysis was to investigate the association between periodontal status and renal allograft function in a cohort of renal transplant patients using different periodontitis case definitions.
  
  
  METHODS
  Fifty-eight kidney transplant patients were included. The subjects were classified into two groups, deterioration or stable/improvement of renal allograft function as expressed by the difference in glomerular filtration rate (GFR) between two time points at least 6 months apart. Chronic periodontitis was defined as: (1) two or more interproximal sites with clinical attachment level (CAL) ≥4 mm or two or more interproximal sites with probing depth (PD) ≥5 mm (DEF1); (2) PD ≥ 5 or CAL ≥ 4 in at least six proximal sites (DEF2); and (3) PD ≥ 5 or CAL ≥ 4 in at least two proximal sites in each quadrant (DEF3).
  
  
  RESULTS
  In a multivariate linear regression model, none of the continuous periodontal variables were significantly associated with deterioration of allograft function. Of the three definitions of chronic periodontitis, only DEF2 emerged as significantly more prevalent in subjects with GFR deterioration and was a statistically significant predictor of GFR deterioration over time.
  
  
  CONCLUSIONS
  These findings underscore the importance of periodontitis ‘case definition’ in the observed statistical associations between periodontitis and systemic disease.
authors.affiliation: Division of Periodontology, Department of Oral Health and Diagnostic Sciences, School of Dental Medicine, University of Connecticut Health Center, Farmington, CT 06030-1710, USA.
authors.forename: E
authors.initials: E
authors.lastname: Ioannidou
authors.forename: M
authors.initials: M
authors.lastname: Shaqman
authors.forename: J
authors.initials: J
authors.lastname: Burleson
authors.forename: A
authors.initials: A
authors.lastname: Dongari-Bagtzoglou
mesh_terms: D002102:Cadaver; D055113:Chronic Periodontitis / Q000145:classification*; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D003774:Dental Plaque Index; D005260:Female; D005500:Follow-Up Studies; D005884:Gingival Hemorrhage / Q000145:classification; D019214:Gingival Overgrowth / Q000145:classification; D005919:Glomerular Filtration Rate / Q000502:physiology; D006084:Graft Rejection / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D007668:Kidney / Q000502:physiology*; D016030:Kidney Transplantation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000145:classification; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000145:classification; D014019:Tissue Donors; D014184:Transplantation, Homologous
chemical_list: D003404:Creatinine
references.citation: Transplantation. 1994 Mar 27;57(6):857-9
references.pmid: 8154032
references.citation: Ann Surg. 2001 Aug;234(2):149-64
references.pmid: 11505060
references.citation: N Engl J Med. 2007 Mar 1;356(9):911-20
references.pmid: 17329698
references.citation: Nephrol Dial Transplant. 2007 Jan;22(1):246-53
references.pmid: 16998222
references.citation: J Periodontol. 2003 Feb;74(2):219-24
references.pmid: 12666711
references.citation: Transplantation. 2004 Aug 27;78(4):557-65
references.pmid: 15446315
references.citation: Clin Transpl. 2001;:1-18
references.pmid: 12211771
references.citation: Pharmacotherapy. 2001 Apr;21(4):405-9
references.pmid: 11310512
references.citation: Transplantation. 1998 Jul 15;66(1):38-43
references.pmid: 9679819
references.citation: Oral Dis. 2008 Mar;14(2):95-101
references.pmid: 18302669
references.citation: Kidney Int. 2002 Jul;62(1):311-8
references.pmid: 12081593
references.citation: Am J Transplant. 2004 Mar;4(3):378-83
references.pmid: 14961990
references.citation: J Clin Periodontol. 2008 May;35(5):385-97
references.pmid: 18341599
references.citation: Arch Surg. 2003 Oct;138(10):1113-9; discussion 1119-20
references.pmid: 14557129
references.citation: J Clin Periodontol. 2005;32 Suppl 6:210-3
references.pmid: 16128839
references.citation: Transplant Proc. 2003 Dec;35(8):2949-52
references.pmid: 14697947
references.citation: J Rheumatol. 2008 Jan;35(1):70-6
references.pmid: 18050377
references.citation: Am J Transplant. 2007 Apr;7(4):880-7
references.pmid: 17391131
references.citation: Transplant Proc. 2008 Jan-Feb;40(1):92-3
references.pmid: 18261555
references.citation: Clin Microbiol Infect. 2007 Oct;13 Suppl 4:3-10
references.pmid: 17716290
references.citation: Kidney Int. 2009 Apr;75(7):746-51
references.pmid: 19165177
references.citation: J Periodontol. 1992 Jun;63(6):548-53
references.pmid: 1625155
references.citation: Ann Periodontol. 2002 Dec;7(1):95-101
references.pmid: 16013222
references.citation: J Periodontol. 2001 Sep;72(9):1221-7
references.pmid: 11577954
references.citation: Ann Intern Med. 2006 Aug 15;145(4):247-54
references.pmid: 16908915
references.citation: BMJ. 2001 Jan 27;322(7280):226-31
references.pmid: 11159626
references.citation: Am J Kidney Dis. 2002 May;39(5):1096-101
references.pmid: 11979355
references.citation: Transpl Immunol. 2006 Nov;16(3-4):148-57
references.pmid: 17138047
references.citation: Stroke. 2003 Sep;34(9):2120-5
references.pmid: 12893951
references.citation: J Periodontol. 1996 Oct;67(10 Suppl):1085-93
references.pmid: 8910827
references.citation: Am J Obstet Gynecol. 2008 Apr;198(4):389.e1-5
references.pmid: 18295179
references.citation: Nephron. 1976;16(1):31-41
references.pmid: 1244564
references.citation: Am J Transplant. 2005 Jun;5(6):1306-11
references.pmid: 15888034
references.citation: J Clin Periodontol. 2008 Apr;35(4):277-90
references.pmid: 18294231
references.citation: Clin Transpl. 1997;:297-303
references.pmid: 9919413
references.citation: J Dent Res. 2007 Aug;86(8):718-22
references.pmid: 17652198
references.citation: Kidney Int. 1996 Feb;49(2):518-24
references.pmid: 8821839
references.citation: J Periodontol. 1994 Feb;65(2):147-53
references.pmid: 8158511
references.citation: Nephrol Dial Transplant. 2003 Apr;18(4):644-7
references.pmid: 12637628
references.citation: Clin Nephrol. 2001 Dec;56(6):S30-4
references.pmid: 11770810
references.citation: Ann Periodontol. 2001 Dec;6(1):146-9
references.pmid: 11887457
references.citation: J Periodontol. 2006 Oct;77(10):1635-42
references.pmid: 17032104
references.citation: Am Heart J. 2007 Nov;154(5):830-7
references.pmid: 17967586
references.citation: Transpl Int. 1989 Dec;2(4):214-7
references.pmid: 2697211
references.citation: J Bone Joint Surg Am. 1999 Oct;81(10):1454-60
references.pmid: 10535596
references.citation: J Clin Periodontol. 2007 Aug;34(8):639-45
references.pmid: 17590155
references.citation: Transplantation. 2000 Mar 15;69(5):869-74
references.pmid: 10755542
references.citation: J Am Soc Nephrol. 1998 Mar;9(3):482-7
references.pmid: 9513912