title: Relationship between periodontal disease and mortality in patients treated with maintenance hemodialysis.
abstract: BACKGROUND
  The relationship between periodontitis and outcomes in patients treated with long-term hemodialysis is controversial. Our previous work suggests that periodontitis is associated with malnutrition and inflammation. Here, we hypothesize that periodontitis is associated with mortality in hemodialysis patients.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  253 patients undergoing hemodialysis at a single hospital-based dialysis facility.
  
  
  METHODS
  Severity of periodontal disease (mild, moderate, or severe based on oral examination of 6 teeth).
  
  
  METHODS
  All-cause and cardiovascular mortality during a 6-year follow-up after an oral health examination of index teeth.
  
  
  RESULTS
  During the 6-year follow-up, 102 patients died. Death occurred in 70.6%, 41.8%, and 24.0% of patients with severe, moderate, and mild/no periodontitis, respectively. Using mild/no periodontitis as the reference group and adjustment for demographic characteristics, comorbid conditions, and selected laboratory values, HRs for all-cause mortality were 1.39 (95% CI, 0.83-2.34) and 1.83 (95% CI, 1.04-3.24) for moderate and severe periodontitis, respectively. HRs for cardiovascular mortality were not statistically significant.
  
  
  CONCLUSIONS
  Single assessment of periodontal disease severity.
  
  
  CONCLUSIONS
  For patients undergoing long-term hemodialysis, periodontitis is associated with increased risk of death. Clinical trials are required to determine whether treatment of periodontitis decreases mortality.
authors.affiliation: Department of Dentistry, Chang Gang Memorial Hospital, Chang Gang University, Taipei, Taiwan.
authors.forename: Li-Ping
authors.initials: LP
authors.lastname: Chen
authors.forename: Chih-Kang
authors.initials: CK
authors.lastname: Chiang
authors.forename: Yu-Sen
authors.initials: YS
authors.lastname: Peng
authors.forename: Shih-Ping
authors.initials: SP
authors.lastname: Hsu
authors.forename: Chien-Yu
authors.initials: CY
authors.lastname: Lin
authors.forename: Chun-Fu
authors.initials: CF
authors.lastname: Lai
authors.forename: Kuan-Yu
authors.initials: KY
authors.lastname: Hung
mesh_terms: D000368:Aged; D002908:Chronic Disease; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D007674:Kidney Diseases / Q000401:mortality* / Q000628:therapy*; D008297:Male; D044342:Malnutrition / Q000150:complications / Q000453:epidemiology; D008875:Middle Aged; D010510:Periodontal Diseases / Q000150:complications* / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D006435:Renal Dialysis; D012720:Severity of Illness Index; D016896:Treatment Outcome