Periodontal treatment in patients with chronic kidney disease: a pilot study

Almeida, Sofia; Figueredo, Carlos Marcelo; Lemos, Carla Cavalheiro da Silva; Bregman, Rachel; Fischer, Ricardo Guimarães

doi:10.1111/jre.12390

Cited by 55 publications

(83 citation statements)

References 35 publications

(47 reference statements)

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“…Almeida et al. (Almeida et al., ) reported an improvement of eGFR from 34.6 ml/min/1.73 m 2 at baseline to 37.6 ml/min/1.73 m 2 at 6 months whereas Graziani et al. () did not find any differences (from 72.8 (9.0) ml/min/1.73 m 2 at baseline to 68.6 (13.1) ml/min/1.73 m 2 at 6 months).…”

Section: Resultsmentioning

confidence: 96%

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Association between periodontitis and chronic kidney disease: Systematic review and meta‐analysis

et al. 2018

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A systematic review and meta-analysis were conducted to evaluate the association between periodontitis (PD) and chronic kidney disease (CKD) and to explore the potential influence of periodontal treatment in patients with CKD. Databases (PubMed, Web of Science, Science direct, Cochrane Database) were screened for relevant articles, focusing on the periodontal status of patients with CKD, published until December 2017. Five hundred and fifty-three articles were identified, and 37 fulfilled the inclusion criteria and were considered in this systematic review. Seventeen articles were included in the meta-analysis and 7 in the review focusing on the impact of periodontal treatment. Most of the identified studies indicated an increased incidence of PD in patients with CKD. Meta-analysis showed an association between CKD and PD, and strength of this association was increased when severe PD was considered (OR = 2.39 (1.70-3.36)). The association could be observed even after adjustment for major CKD risk factors or use of precise diagnosis criteria (OR = 2.26 for severe PD (1.69-3.01)). Analysis of cohort studies indicated an incident rate ratio (IRR) of 1.73. Periodontitis is associated with CKD after multivariable adjustment. Further studies are necessary to determine whether prevention or treatment of PD can reduce the incidence and/or severity of CKD.

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Section: Resultsmentioning

confidence: 96%

“…The evolution of eGFR was analyzed in three studies (Almeida et al., ) (Artese et al., ), (Graziani et al., ). Almeida et al.…”

Section: Resultsmentioning

confidence: 99%

Association between periodontitis and chronic kidney disease: Systematic review and meta‐analysis

et al. 2018

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“…Several studies have attempted to demonstrate a relationship between periodontal disease and renal disease, but the results were inconsistent [24–29]. …”

Section: Discussionmentioning

confidence: 99%

“…Although there are several studies in the literature that compare periodontal disease with renal failure, most studies have compared patients on dialysis (hemodialysis and peritoneal dialysis) to a control group [24–26, 28, 31–33] and in some cases include a predialysis group [27, 29, 34, 35]. Only the study by Garcez et al [36] assesses the oral health status in a group with the IRC in its initial stage (stage 2 CRD) by comparing it to a control group.…”

Section: Discussionmentioning

confidence: 99%

Medical and Periodontal Clinical Parameters in Patients at Different Levels of Chronic Renal Failure

Perozini

Ruivo

Ricardo

et al. 2017

International Journal of Dentistry

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Aim. To assess the clinical periodontal and medical parameters in patients with chronic renal failure (CRF) at different levels of renal disease. Background. CRF is a progressive and irreversible loss of renal function associated with a decline in the glomerular filtration rate. Periodontal disease is a destructive inflammatory disease affecting periodontal tissues that shows high prevalence in patients with CRF. Materials and Methods. 102 CRF patients were included and divided into an early stage group (EG), predialysis group (PDG), and hemodialysis group (HDG). The medical parameters were taken from the patients' records. Results. Periodontal clinical condition differed among the CRF groups. Clinical attachment loss was greater in the HDG and PDG group compared to the EG (p = 0.0364); the same was observed in the Plaque Index (p = 0.0296); the others periodontal parameters did not show any differences. Ferritin levels were significantly higher in the HDG when compared to the EG and PGD (p < 0.0001), and fibrinogen was higher in PDG compared with the others (p < 0.0001); the triglycerides also showed higher values in the HDG compared with the other groups (p < 0.0001). Conclusion. The patients with renal involvement should have a multidisciplinary approach to an improvement in their oral and systemic health.

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“…Essa relação é bidirecional, pois a DRC afeta adversamente a DP assim como a DP pode causar um efeito adverso sobre a DRC, resultando num sistema de mediadores inflamatórios que exacerbam a desordem metabólica dos pacientes em questão [29][30][31] . Estudos recentes apontam um efeito positivo do tratamento periodontal sobre a função renal, levando a redução de marcadores inflamatórios como proteína C reativa, interleucina 6, cistatina C (marcador renal), aumento da taxa de filtração glomerular e ainda contribuindo para o aumento da vasodilatação, visto que a doença periodontal também pode causar uma disfunção endotelial e cardiovascular 32,33 .…”

Section: Resultados O Doença Renal Crônicaunclassified

Alterações bucais e o manejo odontológico dos pacientes com doença renal crônica

Castro¹,

Herculano²,

Gaetti-Jardim³

et al. 2017

Arch Health Invest

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A doença renal crônica é uma síndrome clínica decorrente da perda lenta, progressiva e irreversível da taxa de filtração glomerular, fazendo o paciente necessitar de uma terapia de reposição permanente, a fim de evitar a uremia, que significa o acúmulo de substâncias indesejáveis no sangue. Seu diagnóstico se dá não só pelos sinais e sintomas clínicos como também pelos exames laboratoriais de sangue e urina, em que os valores de ureia e de creatinina estarão aumentados. O cuidado ao paciente deverá ser multiprofissional, sendo o seu tratamento instituído pelo médico de acordo com a progressão da perda da função renal, existindo quatro maneiras, como o tratamento conservador (pré-diálise), a diálise peritoneal, a hemodiálise e, por fim, o transplante renal. É importante e necessário que esses pacientes tenham uma boa saúde bucal para evitar possíveis infecções na cavidade bucal, principalmente durante a hemodiálise, o pré-transplante e o pós-operatório. A doença renal crônica pode apresentar várias manifestações bucais, as quais não são específicas e sim secundárias às manifestações sistêmicas como doença periodontal, xerostomia, lesões na mucosa, infecções bucais entre outras. Uma vez que a função renal está prejudicada, a conduta do cirurgião-dentista deverá ser complexa e delicada e ele precisará adquirir todo o conhecimento para realizar um bom atendimento. Este artigo tem como objetivos abordar conceitos e implicações sobre a doença renal crônica, destacar as alterações bucais, evidenciar as condutas odontológicas e estabelecer um protocolo de atendimento ao paciente acometido por esta desordem.Descritores: Saúde Bucal; Insuficiência Renal Crônica; Doenças Periodontais.

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Periodontal treatment in patients with chronic kidney disease: a pilot study

Abstract: 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.

Cited by 55 publications

References 35 publications

Association between periodontitis and chronic kidney disease: Systematic review and meta‐analysis

Association between periodontitis and chronic kidney disease: Systematic review and meta‐analysis

Medical and Periodontal Clinical Parameters in Patients at Different Levels of Chronic Renal Failure

Alterações bucais e o manejo odontológico dos pacientes com doença renal crônica

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