Effects of non-surgical periodontal therapy on the glomerular filtration rate of the kidney: an exploratory trial.
OBJECTIVE
To determine whether non-surgical periodontal treatment (PT) would exert, in subjects with generalized chronic periodontitis (GCP), some beneficial effect on renal function as indicated by surrogate measures of the glomerular filtration rate (GFR).


METHODS
Twenty GCP systemically healthy subjects were treated with PT. Serum samples were collected at baseline and 1 day, 7, 30, 90 and 180 days after treatment. GFR was evaluated using cystatin C, a serum marker and modification of diet in renal disease (MDRD), an equation involving creatinine, urea and albumin. Serum markers of systemic inflammation such as C-reactive protein (CRP), D-dimer, serum amyloid A (SAA) and fibrinogen were also assessed.


RESULTS
The cystatin C level decreased significantly from baseline to the end of the trial (p<0.01). Conversely, MDRD did not vary. A significant inflammatory reaction was produced by PT in the short term. Greater increases were noted for CRP and SAA within 24 h (p<0.001 versus baseline), while D-dimer (p<0.05) and fibrinogen (p<0.01) showed mild variations. The values of inflammatory markers were normalized after 30 days.


CONCLUSIONS
GFR, as assessed by cystatin C levels, may be positively affected by PT. Because of the exploratory nature of this trial, further research is needed to investigate this preliminary finding.
Graziani
Filippo
F
Department of Surgery, Section of Dentistry and Oral Surgery, University of Pisa, Pisa, Italy. f.graziani@med.unipi.it
Cei
Silvia
S
La Ferla
Fabio
F
Vano
Michele
M
Gabriele
Mario
M
Tonetti
Maurizio
M
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001806:Blood Urea Nitrogen; D002097:C-Reactive Protein / Q000032:analysis; D055113:Chronic Periodontitis / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D003404:Creatinine / Q000097:blood; D055316:Cystatin C / Q000097:blood; D012534:Dental Scaling; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005340:Fibrinogen / Q000032:analysis; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D012709:Serum Albumin / Q000032:analysis; D000685:Serum Amyloid A Protein / Q000032:analysis
D055316:Cystatin C; D005338:Fibrin Fibrinogen Degradation Products; D012709:Serum Albumin; D000685:Serum Amyloid A Protein; C036309:fibrin fragment D; D005340:Fibrinogen; D002097:C-Reactive Protein; D003404:Creatinine