The association of periodontal disease with kidney function decline: A longitudinal retrospective analysis of the MrOS dental study

Vanessa Grubbs, Eric Vittinghoff, George Taylor, Donna Kritz-Silverstein, Neil Powe, Kirsten Bibbins-Domingo, Areef Ishani, Steven R. Cummings

Research output: Contribution to journalArticle

Abstract

Background Identifying modifiable risk factors for chronic kidney disease (CKD) is essential for reducing its burden. Periodontal disease is common, modifiable and has been implicated as a novel potential CKD risk factor, but evidence of its association with kidney function decline over time is limited. Methods In a longitudinal retrospective cohort of 761 elderly men with preserved kidney function [estimated glomerular filtration rate > 60 mL/min/1.73 m2 using a calibrated creatinine and cystatin C (eGFRcr-cys) equation] at baseline, we performed multivariable Poisson's regression to examine the association of severe periodontal disease with incident CKD, defined as incident eGFRcr-cys <60 mL/min/1.73 m2 and rapid (>5% annualized) eGFRcr-cys decline. Severe periodontal disease was defined in two ways: (i) ≥5 mm proximal attachment loss in 30% of teeth examined (European Workshop in Periodontology Group C, European Workshop); and (ii) 2+ interproximal sites with attachment loss ≥6 mm and 1+ interproximal sites with probing depth ≥5 mm (Centers for Disease Control/American Academy of Periodontology, CDC/AAP). Results At baseline, the mean age was 73.4 (SD 4.8) years, the median eGFRcr-cys was 82.4 mL/min/1.73 m2, and 35.5 and 25.4% of participants had severe periodontal disease by European Workshop and CDC/AAP criteria, respectively. After a mean follow-up of 4.9 years (SD 0.3), 56 (7.4%) participants had incident CKD. Severe periodontal disease was associated with a 2-fold greater rate of incident CKD [incidence rate ratio (IRR) 2.01 (1.21-3.44), P = 0.007] after adjusting for confounders compared with not severe periodontal disease by European Workshop criteria but did not reach statistical significance by CDC/AAP criteria [IRR 1.10 (0.63-1.91), P = 0.9]. Conclusions Severe periodontal disease may be associated with incident clinically significant kidney function decline among a cohort of elderly men.

Original languageEnglish (US)
Pages (from-to)466-472
Number of pages7
JournalNephrology Dialysis Transplantation
Volume31
Issue number3
DOIs
StatePublished - Mar 1 2016

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Keywords

  • chronic kidney disease
  • periodontal disease
  • renal function decline
  • risk factors

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

Cite this

Grubbs, V., Vittinghoff, E., Taylor, G., Kritz-Silverstein, D., Powe, N., Bibbins-Domingo, K., Ishani, A., & Cummings, S. R. (2016). The association of periodontal disease with kidney function decline: A longitudinal retrospective analysis of the MrOS dental study. Nephrology Dialysis Transplantation, 31(3), 466-472. https://doi.org/10.1093/ndt/gfv312