Periodontal inflamed surface area in patients on haemodialysis and peritoneal dialysis: a Croatian cross-sectional study

Abstract

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.

Oral health in patients with end‐stage renal disease: A scoping review

“…After removing duplicates of references that were selected from more than one database, 1293 references remained. In total, 43 articles were included for data extraction (Table 1): 1 RCT, 36 cross‐sectional studies, three case–control studies, two cohort studies and one longitudinal study (Al‐Wahadni & Al‐Omari, 2003; Bayraktar et al, 2008; Bots et al, 2004; Bots et al, 2006; Bots et al, 2007; Bruzda‐Zwiech, Szczepańska, & Zwiech, 2014; Bruzda‐Zwiech, Szczepańska, & Zwiech, 2018; Chuang, Sung, Kuo, Huang, & Lee, 2005; de la Rosa García, Mondragón Padilla, Aranda Romo, & Bustamante Ramírez, 2006; Dirschnabel et al, 2011; Eltas, Tozoğlu, Keleş, & Canakci, 2012; Gautam et al, 2014; Gavaldá et al, 1999; Honarmand, Farhad‐Mollashahi, Nakhaee, & Sargolzaie, 2017; Jain et al, 2014; Jung & Chang, 2020; Kaushik et al, 2013; Kho, Lee, Chung, & Kim, 1999; Križan Smojver, Altabas, Knotek, Bašić Jukić, & Aurer, 2020; López‐Pintor, López‐Pintor, Casañas, de Arriba, & Hernández, 2017; Malekmakan, Haghpanah, Pakfetrat, Ebrahimic, & Hasanlic, 2011; Marakoglu, Gursoy, Demirer, & Sezer, 2003; Marinoski, Bokor‐Bratic, Mitic, & Cankovic, 2019; Menezes et al, 2019; Misaki, Fukunaga, & Nakano, 2020; Murali, Narasimhan, Periasamy, & Harikrishnan, 2012; Naruishi et al, 2016; Oliveira et al, 2020; Pallos et al, 2020; Palmer et al, 2016; Parente et al, 2018; Perozini et al, 2017; Schmalz et al, 2016; Schmalz et al, 2017; Schütz et al, 2020; Sekiguchi, Pannuti, Silva, Medina‐Pestana, & Romito, 2012; Sobrado Marinho et al, 2007; Swapna et al, 2013; Tadakamadla, Kumar, & Mamatha, 2014; Torres et al, 2010; Yue et al, 2018; Zhao et al, 2014). The flow chart of the search and selection process is presented in Figure 1.…”

“…Schütz et al described that 59.4% of ESRD patients was diagnosed with severe periodontitis (Schütz et al, 2020). One study reported the total surface area of inflamed periodontal tissue (PISA score) per patient (Križan Smojver et al, 2020).…”

Estimation of the Periodontal Inflamed Surface Area by Simple Oral Examination

“…Many studies have used PISA for evaluation of periodontal conditions. Since PISA reflects the inflammation status of periodontal tissue, these studies focused on the correlation of PISA and systemic diseases [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43], or the correlation of PISA with novel disease markers [41][42][43][44][45][46][47][48]. In the present study, IRT analysis was used to set a cut-off point for the number of bleeding sites and the maximum values of PD in a single tooth.…”

Salivary parameters and periodontal inflammation in obstructive sleep apnoea patients

“…These periodontal parameters were measured following previously published studies for periodontal assessment and diagnosis 45 – 47 . Based on those results, PISA scores were calculated using an online calculator available at www.parsprototo.info as previously described 48 .…”