title: Periodontal treatment in patients with chronic kidney disease: a pilot study.
abstract: OBJECTIVE
  This pilot cohort study evaluated the effect of periodontal treatment on renal function, metabolic markers and asymmetric dimethylarginine (ADMA) in patients with pre-dialysis chronic kidney disease (CKD) presenting chronic periodontitis.
  
  
  METHODS
  Twenty-six patients with CKD and severe chronic periodontitis were selected. Periodontal parameters included plaque index, bleeding on probing, probing pocket depth and clinical attachment level. Estimated glomerular filtration rate (eGFR), triglycerides, total cholesterol, albumin and ADMA levels were evaluated at baseline, 90 and 180 d after periodontal therapy. eGFR was evaluated by the Modification of Diet in Renal Disease equation.
  
  
  RESULTS
  All periodontal clinical parameters significantly improved (p < 0.05) 180 d after periodontal therapy. There was a significant improvement on the median values (25%; 75% percentiles) of eGFR from 34.6 (27; 44.7) mL/min/1.73 m2on baseline to 37.6 (29.7; 57) mL/min/1.73 m2on day 90, and to 37.6 (28.6; 56) mL/min/1.73 m2(p < 0.05) on day 180. ADMA levels significantly reduced 180 d after periodontal treatment. No significant differences were observed at the median values of metabolic markers comparing baseline and 180 d after periodontal treatment.
  
  
  CONCLUSIONS
  The results point to a link of kidney disease with endothelium dysfunction and periodontitis, suggesting that periodontal treatment may be beneficial to the course of CKD.
authors.affiliation: Department of Periodontology, Faculty of Odontology, Rio de Janeiro State University, Rio de Janeiro, Brazil.
authors.forename: S
authors.initials: S
authors.lastname: Almeida
authors.affiliation: Department of Periodontology, Faculty of Odontology, Rio de Janeiro State University, Rio de Janeiro, Brazil.
authors.forename: C M
authors.initials: CM
authors.lastname: Figueredo
authors.affiliation: Nephrology Division, Pedro Ernesto University Hospital, Faculty of Medicine, Rio de Janeiro State University, Rio de Janeiro, Brazil.
authors.forename: C
authors.initials: C
authors.lastname: Lemos
authors.affiliation: Nephrology Division, Pedro Ernesto University Hospital, Faculty of Medicine, Rio de Janeiro State University, Rio de Janeiro, Brazil.
authors.forename: R
authors.initials: R
authors.lastname: Bregman
authors.affiliation: Department of Periodontology, Faculty of Odontology, Rio de Janeiro State University, Rio de Janeiro, Brazil.
authors.forename: R G
authors.initials: RG
authors.lastname: Fischer
mesh_terms: D001120:Arginine / Q000031:analogs & derivatives / Q000097:blood; D002784:Cholesterol / Q000097:blood; D055113:Chronic Periodontitis / Q000150:complications* / Q000628:therapy; D003774:Dental Plaque Index; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D009910:Oral Hygiene; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000150:complications; D010865:Pilot Projects; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D012709:Serum Albumin / Q000032:analysis; D014280:Triglycerides / Q000097:blood
chemical_list: D012709:Serum Albumin; D014280:Triglycerides; C018524:N,N-dimethylarginine; D001120:Arginine; D002784:Cholesterol
keywords: asymmetric dimethylarginine; chronic kidney disease; glomerular filtration rate; periodontitis