title: Periodontitis and chronic kidney disease: a systematic review of the association of diseases and the effect of periodontal treatment on estimated glomerular filtration rate.
abstract: OBJECTIVE
  The aim of this systematic review (SR) was to evaluate the association between periodontitis and chronic kidney disease (CKD) and the effect of periodontal treatment (PT) on the estimated glomerular filtration rate (eGFR).
  
  
  METHODS
  MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched up to and including September 30, 2012 to observational (S1) and interventional (S2) studies on the association of periodontitis with CKD. Studies were considered eligible for inclusion if they reported the eGFR. Search was conducted by two independent reviewers. The methodological quality of the observational studies was assessed using the Newcastle-Ottawa Scale (NOS) adapted for this review, and the Cochrane's Collaboration risk of bias assessment tool. A random-effects odds-ratio meta-analysis was conducted to estimate the degree of association between periodontitis and CKD.
  
  
  RESULTS
  Search strategy identified 2456 potentially eligible articles, of which four cross-sectional, one retrospective, and three interventional studies were included. Four S1, 80.0% reported some degree of association between periodontitis and CKD. Similarly, such an outcome was supported by pooled estimates (OR: 1.65, 95% Confidence Interval: 1.35, 2.01, p < 0.00001, χ(2)  = 1.70, I(2 ) = 0%). All interventional studies found positive outcomes related to treatment.
  
  
  CONCLUSIONS
  There is quite consistent evidence to support the positive association between periodontitis and CKD, as well as the positive effect of PT on eGFR.
authors: Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil. leandro_chambrone@hotmail.com
authors: Leandro
authors: L
authors: Chambrone
authors: Adriana M
authors: AM
authors: Foz
authors: Mariana R
authors: MR
authors: Guglielmetti
authors: Cláudio M
authors: CM
authors: Pannuti
authors: Hilana P C
authors: HP
authors: Artese
authors: Magda
authors: M
authors: Feres
authors: Giuseppe A
authors: GA
authors: Romito
mesh_terms: D015982:Bias; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D010518:Periodontitis / Q000150:complications* / Q000628:therapy; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000503:physiopathology; D012307:Risk Factors; D016896:Treatment Outcome