The relationship between oral diseases and infectious complications in patients under dialysis

Abstract

Objectives Association was investigated between oral health before dialysis and the incidence of systemic infections during dialysis. We hypothesized that low‐grade systemic inflammation caused by poor oral health associates with infectious episodes in patients on dialysis, despite earlier eradication of oral infection foci. Subjects and methods A total of 117 patients (46 with peritoneal and 71 with hemodialysis) were examined and treated at predialysis stage and followed up during dialysis. Number of infection episodes and microorganisms cultured from blood and peritoneal fluid were analyzed. Number of teeth, periodontal inflammatory burden, and total dental index scores were assessed, and salivary matrix metalloproteinase 8, triggering receptor on myeloid cells 1, peptidoglycan recognition protein 1 (PGLYRP1), and interleukin‐1β were measured. Results In hemodialysis, 134 infection episodes were recorded, while peritoneal dialysis group had 77 peritonitis episodes. Culture‐negative samples were 69% in hemodialysis and 23% in peritoneal dialysis group. Staphylococci were the most frequently associated microorganisms. Infections during dialysis did neither associate with oral health parameters nor associate with salivary inflammatory biomarkers, except for PGLYRP1, which associated with number of infection episodes during hemodialysis (p = .046). Conclusions A number of infection episodes during hemodialysis were associated with salivary PGLYRP1 but not the other salivary markers or oral infection markers.

Blood and Salivary Inflammatory Biomarkers Profile in Patients with Chronic Kidney Disease and Periodontal Disease: A Systematic Review

“…Subsequently, there was a full-text assessment, in which 31 articles were excluded based on the exclusion criteria detailed in Table 3 . Twelve articles [ 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 ] met the inclusion criteria and were included in the current review ( Figure 1 ).…”

“…Of the 12 studies, 11 conducted a blood collection, and only one [ 43 ] used saliva to obtain the required data. Different types of biomarkers were analyzed, such as metabolism, nutritional, inflammatory, and bacterial biomarkers.…”

Relationship between Apical Periodontitis and Metabolic Syndrome and Cardiovascular Events: A Cross-Sectional Study

“…The possibility of comparisons between studies carried out with calibrated observers makes this system attractive [ 44 ] to better standardize the evaluations and allow comparison with the results of other researchers. Additionally, although the PAI score system was first described for periapical radiographs [ 26 ], it has been used in many epidemiological studies for panoramic radiographs [ 22 , 24 , 27 , 37 , 38 , 45 , 46 ]. The possibility of comparisons among the studies carried out with calibrated observers makes this system attractive [ 41 ], in order to better standardize the evaluations and allow the comparison with the result of other investigators.…”

“…The total oral inflammatory burden was determined using the modified TDI [ 32 ], widely used in studies investigating the association between oral infections and cardiovascular diseases [ 19 , 24 , 25 , 45 ].…”

Elevated serum TREM-1 is associated with periodontitis and disease activity in rheumatoid arthritis

“…PGLYRP1 levels were elevated in saliva and GCF of patients with periodontitis, and initial periodontal therapy decreased PGLYRP1 levels in these patients with a stronger effect in non-smokers [27][28][29] . Furthermore, TREM-1 and PGLYRP1 have been investigated in the context of the periodontal and systemic disease link 28,[30][31][32] . In this regard, higher levels of salivary TREM-1 and PGLYRP1 were associated with poorer oral health in chronic kidney disease patients with concomitant periodontitis, and a positive correlation was found between salivary TREM-1 and PGLYRP1 levels 28 .…”