American Journal of Kidney Diseases
Volume 51, Issue 1 , Pages 45-52, January 2008

Periodontal Disease and Other Nontraditional Risk Factors for CKD

  • Monica A. Fisher, PhD, DDS, MPH

      Affiliations

    • Case Western Reserve University, Cleveland, OH
    • Corresponding Author InformationAddress correspondence to Monica A. Fisher, PhD, DDS, MPH, Associate Professor, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106-4905.
    • ,
  • George W. Taylor, DMD, DrPH

      Affiliations

    • University of Michigan, Ann Arbor, MI
    • ,
  • Brent J. Shelton, PhD

      Affiliations

    • University of Kentucky, Lexington, KY.
    • ,
  • Kenneth A. Jamerson, MD

      Affiliations

    • University of Michigan, Ann Arbor, MI
    • ,
  • Mahboob Rahman, MD, MS

      Affiliations

    • Case Western Reserve University, Cleveland, OH
    • ,
  • Akinlolu O. Ojo, MD, PhD

      Affiliations

    • University of Michigan, Ann Arbor, MI
    • ,
  • Ashwini R. Sehgal, MD

      Affiliations

    • Case Western Reserve University, Cleveland, OH

Received 2 June 2007; accepted 18 September 2007.

Background

Chronic kidney disease, undiagnosed in a significant number of adults, is a public health problem. Given the systemic inflammatory response to periodontal disease, we hypothesized that periodontal disease could be associated with chronic kidney disease.

Study Design

Cross-sectional.

Setting & Participants

We identified 12,947 adults 18 years or older with information for kidney function and at least one risk factor in the Third National Health and Nutrition Examination Survey.

Predictor

The main predictor was periodontal status. Other nontraditional and traditional risk factors included socioeconomic status, health status, health behavior, biomarker levels, anthropometric assessment, and health care utilization.

Outcomes & Measurements

Chronic kidney disease was defined using the Kidney Disease Outcomes Quality Initiative stages 3 and 4 with a moderate to severe decrease in kidney function (glomerular filtration rate, 15 to 59 mL/min/1.73 m2). Univariable and multivariable logistic regression models assessed the associations between chronic kidney disease and periodontal disease and other nontraditional risk factors.

Results

Chronic kidney disease prevalence was 3.6%; periodontal disease prevalence was 6.0%; and edentulism prevalence was 10.5%. Adults with periodontal disease and edentulous adults were twice as likely to have chronic kidney disease (adjusted odds ratio, 1.60; 95% confidence interval, 1.16 to 2.21; adjusted odds ratio, 1.85; 95% confidence interval, 1.34 to 2.56, respectively) after simultaneously adjusting for other traditional and nontraditional risk factors.

Limitations

Temporal association is unknown.

Conclusions

Periodontal disease and its severe consequence, edentulism, were independently associated with chronic kidney disease after adjusting for other traditional and nontraditional risk factors. This model could contribute to identifying individuals at risk of chronic kidney disease and reduce its burden.

Index Words: Chronic kidney disease, diabetes mellitus, edentulism, glomerular filtration rate, hypertension, macroalbuminuria, periodontal disease

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 This work was done at Case Western Reserve University.

PII: S0272-6386(07)01368-6

doi:10.1053/j.ajkd.2007.09.018

American Journal of Kidney Diseases
Volume 51, Issue 1 , Pages 45-52, January 2008

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