Background: The decision to initiate dialysis treatment via haemodialysis (HD) or peritoneal dialysis (PD) often involves the consideration of complex factors and remains a matter of debate. The purpose of this study was to quantify the inflammatory burden that periodontitis causes in dialysis patients and to examine whether patients on PD and HD differ in terms of the periodontal inflamed surface area (PISA), which can be helpful for selecting the most appropriate dialysis modality. Methods: A cross-sectional study was performed on 58 consecutive patients on HD and 31 consecutive patients on PD. PISA was calculated using measurements of the clinical attachment level, recession and bleeding on probing. We performed the primary analysis using multivariable robust regression. Results: Patients on PD had a 746 mm 2 (93%) lower mean PISA than patients on HD after adjustment for 20 possible confounders, including the duration of dialysis. The type of dialysis was independently correlated with the PISA (semipartial correlation: − 0.50; p = 0.017; false discovery rate < 5%). After adjusting for confounding factors, the correlation between the duration and type of dialysis was not significant (F (2,44) = 0.01; p = 0.994; η 2 = 0.00). Differences in the PISA between patients who had undergone dialysis for less than a year, 2-3 years or ≥ 3 years were not significantly different in either of the two dialysis groups. Conclusions: PISA levels in Croatian patients on dialysis indicate a high need for periodontal treatment. PD is associated with a smaller PISA independent of many sociodemographic, lifestyle, laboratory and clinical factors. The duration of dialysis does not influence PISA levels. Trial registration: ISRCTN17887630. A clinical study to investigate gum infection in patients undergoing kidney dialysis.

Background: Periodontitis is an inflammatory periodontal disease that is caused by bacterial plaque and destroys the connective tissue and bone that support the teeth. Patients with chronic kidney disease have damaged immunological systems because of uremic toxins and are thus prone to infections. The decision to initiate dialysis treatment via haemodialysis (HD) or peritoneal dialysis (PD) is often complex and remains a matter of debate. Although it has been shown that PD can provide similar or better survival rates and better quality of life and that PD is more economical than HD, PD patients represent only 11% of the global dialysis population. PD also better removes middle molecules (uremic toxins) than haemodialysis (HD). The purpose of this study was to investigate the level of inflammatory burden presented by PISA levels in dialysis patients in Croatia to compare PISA between HD and PD patients, thus providing another aspect for consideration in the selection of the optimal dialysis modality. Methods: A cross-sectional study was performed on 58 consecutive patients on HD and 31 consecutive patients on PD. PISA was calculated using measurements of the clinical attachment level, recession and bleeding on probing. We performed the primary analysis using multivariable robust regression. Results: Patients on PD had a 746 mm2 (93%) lower mean PISA than patients on HD after adjustment for 20 possible confounders, including the duration of dialysis. The type of dialysis was independently correlated with PISA (semipartial correlation: -0.50; p=0.017; false discovery rate<5%). Conclusions: PISA levels in dialysis Croatian patients indicate a high need for periodontal treatment. PD is associated with a smaller PISA independent of many sociodemographic, lifestyle, laboratory and clinical factors. The duration of dialysis does not influence PISA levels.

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Background: The decision to initiate dialysis treatment via haemodialysis (HD) or peritoneal dialysis (PD) often involves the consideration of complex factors and remains a matter of debate. The purpose of this study was to quantify the inflammatory burden that periodontitis causes in dialysis patients and to examine whether patients on PD and HD differ in terms of the periodontal inflamed surface area (PISA), which can be helpful for selecting the most appropriate dialysis modality. Methods: A cross-sectional study was performed on 58 consecutive patients on HD and 31 consecutive patients on PD. PISA was calculated using measurements of the clinical attachment level, recession and bleeding on probing. We performed the primary analysis using multivariable robust regression.Results: Patients on PD had a 746 mm2 (93%) lower mean PISA than patients on HD after adjustment for 20 possible confounders, including the duration of dialysis. The type of dialysis was independently correlated with the PISA (semipartial correlation: -0.50; p=0.017; false discovery rate<5%). After adjusting for confounding factors, the correlation between the duration and type of dialysis was not significant (F (2,44)=0.01; p=0.994; η2=0.00). Differences in the PISA between patients who had undergone dialysis for less than a year, 2-3 years or ≥3 years were not significantly different in either of the two dialysis groups. Conclusions: PISA levels in Croatian patients on dialysis indicate a high need for periodontal treatment. PD is associated with a smaller PISA independent of many sociodemographic, lifestyle, laboratory and clinical factors. The duration of dialysis does not influence PISA levels.

Background: Periodontitis is an inflammatory periodontal disease that is caused by bacterial plaque and destroys the connective tissue and bone that support the teeth. Patients with chronic kidney disease have damaged immunological systems because of uremic toxins and are thus prone to infections. Peritoneal dialysis (PD) is better for the removal of middle molecules (uremic toxins) than haemodialysis (HD). Our hypothesis was that PD is associated with a lower periodontal inflamed surface area (PISA). Methods: A cross-sectional study was performed on 58 consecutive patients on HD and 31 consecutive patients on PD. PISA was calculated using measurements of the clinical attachment level, recession and bleeding on probing. Results: Patients on PD had a 691 mm 2 (89%) lower PISA than patients on HD after adjustment for 15 possible confounders, including the duration of dialysis. The type of dialysis was independently correlated with PISA (semipartial correlation: -0.30; p=0.009; false discovery rate<5%). Conclusions: PD is associated with a smaller PISA independently of a large number of sociodemographic, lifestyle, laboratory and clinical factors.