The impact of periodontal disease on physical and psychological domains in long-term hemodialysis patients: a cross-sectional study.
OBJECTIVE
Periodontal disease is a chronic infectious disease. Individuals with end-stage kidney disease (ESKD) experience impaired quality of life (QoL) and low oral health. This is the first comprehensive study which aimed to explore the link between periodontal disease and quality of life, assessed with the Short Form 36-Item Health Survey in hemodialysis patients.


METHODS
In total, 101 patients (57 females) with ESKD were recruited from two Romanian dialysis centers. Periodontal disease assessment included the measurement of periodontal disease index, with its three components: the gingival and periodontal index (GP), the bacterial plaque index (PI) and the calculus index (CI). For assessing QoL, we used the Short Form 36-Item Health Survey (SF-36), with its two components: physical component (PCS) and mental component (MCS).


RESULTS
The mean age was 52.5 ± 14.3 years. The dialysis vintage was 6.7 ± 5.6 years. According to periodontal status, the mean value of GP was 4.0 ± 1.3, mean PI was 1.8 ± 0.9, and mean CI was 1.3 ± 0.7. Regarding the QoL, the means for PCS and MCS were 38.0 ± 17.3 and 45.0 ± 16.3, respectively. In univariate analysis, the physical and mental components of QoL were significantly associated with the gingival and periodontal index, the bacterial plaque index and the calculus index. In the multivariable linear regression, only the gingival and periodontal index remained significantly associated with physical component (β = -3.26, p = 0.04, 95% CI -6.39 to -0.13) and mental component (β = -5.57, p = 0.001, 95% CI -8.74 to -2.41) of QoL.


CONCLUSIONS
Our study shows a high prevalence and severity of periodontal disease. The gingival and periodontal index was associated with low QoL, both on physical and on mental components.
Nephrology Department, Faculty of Medicine, University of Medicine and Pharmacy "Gr. T. Popa", Iasi, Romania.
Gabriel
G
Veisa
Dialysis and Renal Transplantation Center, "Dr. C. I. Parhon" University Hospital, Iasi, Romania. alexandra_tash@yahoo.com.|Medical Deontology and Bioethics Department, Faculty of Medicine, University of Medicine and Pharmacy "Gr. T. Popa", Iasi, Romania. alexandra_tash@yahoo.com.
Alexandra
A
Tasmoc
Nephrology Department, Faculty of Medicine, University of Medicine and Pharmacy "Gr. T. Popa", Iasi, Romania.
Ionut
I
Nistor
Nephrology Department, Faculty of Medicine, University of Medicine and Pharmacy "Gr. T. Popa", Iasi, Romania.
Liviu
L
Segall
Nephrology Department, Faculty of Medicine, University of Medicine and Pharmacy "Gr. T. Popa", Iasi, Romania.
Dimitrie
D
Siriopol
Periodontology Department, Faculty of Dental Medicine, University of Medicine and Pharmacy "Gr. T. Popa", Iasi, Romania.
Sorina Mihaela
SM
Solomon
Nephrology Department, Faculty of Medicine, University of Medicine and Pharmacy "Gr. T. Popa", Iasi, Romania.
Mihaela Dora
MD
Donciu
Nephrology Department, Faculty of Medicine, University of Medicine and Pharmacy "Gr. T. Popa", Iasi, Romania.
Luminita
L
Voroneanu
Nephrology Department, Faculty of Medicine, University of Medicine and Pharmacy "Gr. T. Popa", Iasi, Romania.
Andra
A
Nastasa
Nephrology Department, Faculty of Medicine, University of Medicine and Pharmacy "Gr. T. Popa", Iasi, Romania.
Adrian
A
Covic
D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003774:Dental Plaque Index; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010510:Periodontal Diseases / Q000150:complications* / Q000523:psychology*; D010512:Periodontal Index; D010865:Pilot Projects; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology; D006435:Renal Dialysis; D012720:Severity of Illness Index; D013997:Time Factors
End-stage kidney disease; Hemodialysis; Periodontal disease; Quality of life