Prevalence and risk factors of CKD in Chinese patients with periodontal disease

PLoS One. 2013 Aug 7;8(8):e70767. doi: 10.1371/journal.pone.0070767. eCollection 2013.

Abstract

Background: Periodontal disease is common among adults and is associated with an increasing risk of chronic kidney disease (CKD). We aimed to investigate the prevalence and risk factors of CKD in patients with periodontal disease in China.

Methods: In the current cross-sectional study, patients with periodontal disease were included from Guangdong Provincial Stomatological Hospital between March 2011 and August 2011. CKD was defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m(2), the presence of albuminuria, or hematuria. All patients with periodontal disease underwent a periodontal examination, including periodontal probing pocket depth, gingival recession, and clinical attachment level by Florida Probe. They completed a questionnaire and had blood and urine samples taken. The adjusted prevalence of indicators of kidney damage was calculated and risk factors associated with CKD were analyzed.

Results: A total of 1392 patients with periodontal disease were invited to participate this study and 1268 completed the survey and examination. After adjusting for age and sex, the prevalence of reduced eGFR, albuminuria, and hematuria was 2.7% (95% CI 1.7-3.7), 6.7% (95% CI 5.5-8.1) and 10.9% (95% CI 9.2-12.5), respectively. The adjusted prevalence of CKD was 18.2% (95% CI 16.2-20.3). Age, male, diabetes, hypertension, history of CKD, hyperuricemia, and interleukin-6 levels (≥7.54 ng/L) were independent risk factors for reduced eGFR. Female, diabetes, hypertension, history of CKD, hyperuricemia, high level of cholesterol, and high sensitivity C-reactive protein (hsCRP) (≥ 1.03 mg/L) and TNF-α levels (≥ 1.12 ng/L) were independently associated with an increased risk of albuminuria. Female, lower education (<high school), and history of CKD were independent risk factors for hematuria.

Conclusions: 18.2% of Chinese patients with periodontal disease have proteinuria, hematuria, or reduced eGFR, indicating the presence of kidney damage. Whether prevention or treatment of periodontal disease can reduce the high prevalence of CKD, however, remains to be further investigated.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Asian People*
  • C-Reactive Protein / metabolism
  • China / epidemiology
  • Cholesterol / blood
  • Cross-Sectional Studies
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Periodontal Diseases / complications*
  • Periodontal Diseases / epidemiology
  • Periodontal Diseases / ethnology
  • Prevalence
  • Renal Insufficiency, Chronic / complications*
  • Renal Insufficiency, Chronic / epidemiology
  • Renal Insufficiency, Chronic / ethnology
  • Risk Factors
  • Tumor Necrosis Factor-alpha / blood

Substances

  • Tumor Necrosis Factor-alpha
  • C-Reactive Protein
  • Cholesterol

Grants and funding

This work was supported by grants from National Key Technology Research and Development Program of the Ministry of Science and Technology of China (No.2011BAI10B05); Guangzhou Committee of Science and Technology, China (Grant No 2010U1-E00831), and 5010 clinical Program of Sun Yat-sen University (Grant No 2007007) to Xueqing Yu. Jincai Zhang was supported by grants from the Scientific and Technologic Committee of Guangdong province (No. 2010B031600117). Kejin Liu was supported by grants from the Scientific and Technologic Committee of Guangdong province (No. 2011B080701088) and Medical Scientific Research Foundation of Guangdong Province (B2011035). Qinghua Liu was supported by grants from Doctoral Program of Higher Education of China (20100171120067) and Natural Science Foundation of Guangdong Province (10451008901005957). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.