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Association Between Periodontal Disease and Kidney Function Decline in African Americans: The Jackson Heart Study.

TitleAssociation Between Periodontal Disease and Kidney Function Decline in African Americans: The Jackson Heart Study.
Publication TypeJournal Article
Year of Publication2015
AuthorsGrubbs V, Vittinghoff E, Beck JD, Kshirsagar AV, Wang W, Griswold ME, Powe NR, Correa A
Secondary AuthorsYoung B
JournalJ Periodontol
Volume86
Issue10
Pagination1126-32
Date Published2015 Oct
ISSN1943-3670
KeywordsAfrican Americans, Age Factors, Aged, Cohort Studies, Creatinine, Diabetes Complications, Disease Progression, Female, Follow-Up Studies, Gingival Recession, Glomerular Filtration Rate, Humans, Hypertension, Income, Male, Middle Aged, Periodontal Attachment Loss, Periodontal Diseases, Periodontal Index, Periodontal Pocket, Renal Insufficiency, Chronic, Retrospective Studies, Risk Factors, Sex Factors, Smoking
Abstract

BACKGROUND: Chronic kidney disease (CKD) remains a prevalent public health problem that disproportionately affects African Americans, despite intense efforts targeting traditional risk factors. Periodontal disease, a chronic bacterial infection of the oral cavity, is both common and modifiable and has been implicated as a novel potential CKD risk factor. The authors seek to examine to what extent periodontal disease is associated with kidney function decline.

METHODS: This retrospective cohort study examines 699 African American participants with preserved kidney function (defined by estimated glomerular filtration rate (eGFR) >60 mL/minute/1.73 m(2) at baseline) who underwent complete dental examinations as part of the Dental-Atherosclerosis Risk in Communities study (1996 to 1998) and subsequently enrolled in the Jackson Heart Study (2000 to 2004). Using multivariable Poisson regression, the authors examined the association of periodontal disease (severe versus non-severe) with incident CKD, defined as incident eGFR

RESULTS: Mean (± SD) age at baseline was 65.4 (± 5.2) years, and 16.3% (n = 114) had severe periodontal disease. There were 21 cases (3.0%) of incident CKD after a mean follow-up of 4.8 (± 0.6) years. Compared with participants with non-severe periodontal disease, those with severe periodontal disease had a four-fold greater rate of incident CKD (adjusted incidence rate ratio 4.18 [95% confidence interval 1.68 to 10.39], P = 0.002).

CONCLUSIONS: Severe periodontal disease is prevalent among a population at high risk for CKD and is associated with clinically significant kidney function decline. Further research is needed to determine if periodontal disease treatment alters the trajectory of renal deterioration.

DOI10.1902/jop.2015.150195
Alternate JournalJ Periodontol
PubMed ID26110451
PubMed Central IDPMC4831049
Grant ListR01 DK102134 / DK / NIDDK NIH HHS / United States
HHSN268201300049C / / PHS HHS / United States
1R01DK102134-01 / DK / NIDDK NIH HHS / United States
HHSN268201300048C / / PHS HHS / United States
HHSN268201300047C / / PHS HHS / United States
HHSN268201300048C / HL / NHLBI NIH HHS / United States
HHSN268201300049C / HL / NHLBI NIH HHS / United States
1K23DK093710-01A1 / DK / NIDDK NIH HHS / United States
HHSN268201300050C / / PHS HHS / United States
HHSN268201300046C / / PHS HHS / United States
HHSN268201300047C / HL / NHLBI NIH HHS / United States
HHSN268201300050C / HL / NHLBI NIH HHS / United States
K23 DK093710 / DK / NIDDK NIH HHS / United States
HHSN268201300046C / HL / NHLBI NIH HHS / United States