BACKGROUND: The relationship between periodontitis and outcomes in patients treated with long-term hemodialysis is controversial. Our previous work suggests that periodontitis is associated with malnutrition and inflammation. Here, we hypothesize that periodontitis is associated with mortality in hemodialysis patients. STUDY DESIGN: Prospective observational study. SETTING & PARTICIPANTS: 253 patients undergoing hemodialysis at a single hospital-based dialysis facility. PREDICTOR: Severity of periodontal disease (mild, moderate, or severe based on oral examination of 6 teeth). OUTCOMES & MEASUREMENTS: All-cause and cardiovascular mortality during a 6-year follow-up after an oral health examination of index teeth. RESULTS: During the 6-year follow-up, 102 patients died. Death occurred in 70.6%, 41.8%, and 24.0% of patients with severe, moderate, and mild/no periodontitis, respectively. Using mild/no periodontitis as the reference group and adjustment for demographic characteristics, comorbid conditions, and selected laboratory values, HRs for all-cause mortality were 1.39 (95% CI, 0.83-2.34) and 1.83 (95% CI, 1.04-3.24) for moderate and severe periodontitis, respectively. HRs for cardiovascular mortality were not statistically significant. LIMITATIONS: Single assessment of periodontal disease severity. CONCLUSIONS: For patients undergoing long-term hemodialysis, periodontitis is associated with increased risk of death. Clinical trials are required to determine whether treatment of periodontitis decreases mortality. Copyright Â
BACKGROUND: The relationship between periodontitis and outcomes in patients treated with long-term hemodialysis is controversial. Our previous work suggests that periodontitis is associated with malnutrition and inflammation. Here, we hypothesize that periodontitis is associated with mortality in hemodialysis patients. STUDY DESIGN: Prospective observational study. SETTING & PARTICIPANTS: 253 patients undergoing hemodialysis at a single hospital-based dialysis facility. PREDICTOR: Severity of periodontal disease (mild, moderate, or severe based on oral examination of 6 teeth). OUTCOMES & MEASUREMENTS: All-cause and cardiovascular mortality during a 6-year follow-up after an oral health examination of index teeth. RESULTS: During the 6-year follow-up, 102 patients died. Death occurred in 70.6%, 41.8%, and 24.0% of patients with severe, moderate, and mild/no periodontitis, respectively. Using mild/no periodontitis as the reference group and adjustment for demographic characteristics, comorbid conditions, and selected laboratory values, HRs for all-cause mortality were 1.39 (95% CI, 0.83-2.34) and 1.83 (95% CI, 1.04-3.24) for moderate and severe periodontitis, respectively. HRs for cardiovascular mortality were not statistically significant. LIMITATIONS: Single assessment of periodontal disease severity. CONCLUSIONS: For patients undergoing long-term hemodialysis, periodontitis is associated with increased risk of death. Clinical trials are required to determine whether treatment of periodontitis decreases mortality. Copyright Â
Authors: Meggan M H Wehmeyer; Abhijit V Kshirsagar; Silvana P Barros; James D Beck; Kevin L Moss; John S Preisser; Steven Offenbacher Journal: Am J Kidney Dis Date: 2012-12-20 Impact factor: 8.860
Authors: Giovanni F M Strippoli; Suetonia C Palmer; Marinella Ruospo; Patrizia Natale; Valeria Saglimbene; Jonathan C Craig; Fabio Pellegrini; Massimo Petruzzi; Michele De Benedittis; Pauline Ford; David W Johnson; Eduardo Celia; Ruben Gelfman; Miguel R Leal; Marietta Torok; Paul Stroumza; Anna Bednarek-Skublewska; Jan Dulawa; Luc Frantzen; Juan Nin Ferrari; Domingo del Castillo; Jorgen Hegbrant; Charlotta Wollheim; Letitzia Gargano Journal: BMC Nephrol Date: 2013-04-19 Impact factor: 2.388