title: Treatment of chronic periodontitis decreases serum prohepcidin levels in patients with chronic kidney disease.
abstract: OBJECTIVE
  To determine the impact of periodontal treatment on serum levels of prohepcidin (the prohormone of hepcidin) and systemic inflammation markers, as well as correlations among these markers, in patients with chronic periodontitis and chronic kidney disease who were not undergoing dialysis.
  
  
  METHODS
  We included 56 chronic periodontitis patients, 36 with chronic kidney disease and 20 without systemic diseases and with normal renal function (control group). Chronic kidney disease was defined as suggested by the clinical practice guidelines in the National Kidney Foundation. Chronic periodontitis was defined through clinical attachment level and by probing pocket depth, according to the American Association of Periodontology. The inflammatory markers ultrasensitive C-reactive protein, interleukin-6, and prohepcidin were evaluated before and 3 months after periodontal treatment.
  
  
  RESULTS
  The efficacy of periodontal treatment was confirmed by the improvement in clinical parameters of chronic periodontitis in the control and chronic kidney disease groups. Periodontal treatment resulted in significant reductions in ultrasensitive C-reactive protein, interleukin-6 and serum prohepcidin levels in both groups. Moreover, in multivariate linear regression, the reduction in prohepcidin after periodontal treatment was significantly and independently associated with interleukin-6 levels in the control group.
  
  
  CONCLUSIONS
  By inducing a decline in the systemic inflammatory response and a decrease in serum prohepcidin, successful periodontal treatment may represent an important means of ameliorating the inflammatory burden seen in patients with chronic kidney disease.
  
  
  BACKGROUND
  ISRCTN59866656.
authors.affiliation: Department of Dentistry Clinics, Federal University, Juiz de Fora, MG, Brazil. eduardo.vilela@ufjf.edu.br
authors.forename: Eduardo Machado
authors.initials: EM
authors.lastname: Vilela
authors.forename: Jessica Amaral
authors.initials: JA
authors.lastname: Bastos
authors.forename: Natalia
authors.initials: N
authors.lastname: Fernandes
authors.forename: Ana Paula
authors.initials: AP
authors.lastname: Ferreira
authors.forename: Alfredo
authors.initials: A
authors.lastname: Chaoubah
authors.forename: Marcus Gomes
authors.initials: MG
authors.lastname: Bastos
mesh_terms: D000328:Adult; D023181:Antimicrobial Cationic Peptides / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D055113:Chronic Periodontitis / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D064451:Hepcidins; D006801:Humans; D007249:Inflammation / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D007676:Kidney Failure, Chronic / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011498:Protein Precursors / Q000097:blood*; D013357:Subgingival Curettage / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D023181:Antimicrobial Cationic Peptides; D015415:Biomarkers; D064451:Hepcidins; D015850:Interleukin-6; D011498:Protein Precursors; D002097:C-Reactive Protein