Association between Serum Creatinine and Periodontal Disease Severity—A Comparative Clinicobiochemical Study

Abstract

Objectives: Periodontitis is a chronic inflammatory disease of the periodontium that produces adverse systemic effects including diabetes mellitus, adverse pregnancy outcomes, respiratory illness, etc. Based on new studies, chronic inflammation is speculated as a risk factor for impairment of kidney function. Periodontitis, as long time inflammation is posed as one of the nontraditional risk factors for end-stage renal diseases. Literature search reveals contradicting evidence on the influence of periodontal infection and inflammation on the renal function. In lieu of the above, this study aims in estimating and comparing the serum creatinine (SCR) levels with periodontal disease status in systemically healthy subjects. Materials and methods: A total of 45 systemically healthy patients were recruited, and based on their periodontal status, they were divided into two groups: Group I (n = 22)-subjects with periodontitis and Group II (n = 23)-periodontally healthy subjects. Group I was again categorized into mild (CAL 1-2 mm), moderate (CAL 2-4 mm), and severe (CAL ≥ 5 mm) based on the severity of the periodontal disease. After assessing the clinical parameters, blood was collected for SCR estimation. The comparison between PPD, CAL, and SCR was done using the paired t-test. The comparison of SCR levels with severity of the periodontitis (CAL) was done using ANOVA. All the statistical analyzes were performed using SPSS 17 software. Results: The SCR value in Group I was 1.06 ± 0.13 and in Group II, 1.17 ± 0.16. Using the paired t-test to compare the creatinine values revealed that the difference between the two groups was statistically significant (p = 0.00001). By comparing the SCR levels with the severity of the periodontal disease, the mean value for mild periodontitis cases was 1.1 ± 0.12; for moderate periodontitis cases, 1.09 ± 0.25; and for severe periodontitis cases, 1.14 ± 0.14. ANOVA test values between the groups showed a statistical significance (p < 0.01). Conclusion: The results from this study showed an inverse relationship between SCR levels and periodontitis. The causal relationship between periodontitis and low SCR could not be established. This inverse relationship might confound the analysis of the link between renal function and periodontal disease. From the results of this study, we conclude that considering other indices such as cystatin C and creatinine clearance is preferable, to explore the association between renal function and periodontal disease.