title: Association between chronic azotemic kidney disease and the severity of periodontal disease in dogs.
abstract: Naturally occurring periodontal disease affects >75% of dogs and has been associated with cardiac lesions and presumptive endocarditis. However, the relationships between periodontal disease and chronic kidney disease (CKD) in dogs have not been studied. In a retrospective longitudinal study the incidence of azotemic CKD was compared between a cohort of 164,706 dogs with periodontal disease and a cohort of age-matched dogs with no periodontal disease from a national primary care practice. These dogs contributed 415,971 dog-years of follow-up from 2002 to 2008. Hazard ratios and 95% confidence intervals from Cox regression were used to compare the incidence of azotemic CKD in dogs with stage 1, 2, or 3/4 periodontal disease to dogs with no periodontal disease. The hazard ratio for azotemic CKD increased with increasing severity of periodontal disease (stage 1 hazard ratio=1.8, 95% confidence interval: 1.6, 2.1; stage 2 hazard ratio=2.0, 95% confidence interval: 1.7, 2.3; stage 3/4 hazard ratio=2.7, 95% confidence interval: 2.3, 3.0; P(trend)=<0.0001) after adjustment for age, gender, neuter status, breed, body weight, number of hospital visits, and dental procedures. Increasing severity of periodontal disease was also associated with serum creatinine >1.4 mg/dl and blood urea nitrogen >36 mg/dl, independent of a veterinarian's clinical diagnosis of CKD.
authors.affiliation: Department of Emergency Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7594, USA. larry glickman@med.unc.edu
authors.forename: Lawrence T
authors.initials: LT
authors.lastname: Glickman
authors.forename: Nita W
authors.initials: NW
authors.lastname: Glickman
authors.forename: George E
authors.initials: GE
authors.lastname: Moore
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Lund
authors.forename: Gary C
authors.initials: GC
authors.lastname: Lantz
authors.forename: Barrak M
authors.initials: BM
authors.lastname: Pressler
mesh_terms: D000818:Animals; D053099:Azotemia / Q000453:epidemiology / Q000473:pathology / Q000662:veterinary*; D016022:Case-Control Studies; D015331:Cohort Studies; D015897:Comorbidity; D004283:Dog Diseases / Q000453:epidemiology* / Q000473:pathology; D004285:Dogs; D005260:Female; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000473:pathology / Q000662:veterinary*; D008297:Male; D010510:Periodontal Diseases / Q000150:complications / Q000453:epidemiology / Q000473:pathology / Q000662:veterinary*; D016016:Proportional Hazards Models; D012307:Risk Factors; D012720:Severity of Illness Index