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 journalArticlepeer-review

23 Scopus citations

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

Bibliographical note

Funding Information:
We thank the participants and staff of the MrOS study. V.G. was supported by grant 1K23DK093710-01A1 from the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) and by the Harold Amos Medical Faculty Development Program of the Robert Wood Johnson Foundation. This project was supported by the National Center for Advancing Translational Sciences, National Institutes of Health, through UCSF-CTSI Grant Number TL1TR000144. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. The MrOS study is supported by National Institutes of Health funding. The following institutes provide support: the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the National Institute on Aging (NIA), the National Center for Research Resources (NCRR) and NIH Roadmap for Medical Research under the following grant numbers: U01 AR45580, U01 AR45614, U01 AR45632, U01 AR45647, U01 AR45654, U01 AR45583, U01 AG18197, U01 AG027810 and UL1 TR000128. The National Institute for Dental and Craniofacial Research (NIDCR) provides funding for the MrOS Dental ancillary study ?Oral and Skeletal Bone Loss in Older Men? under the Grant Number R01 DE014386. Cystatin C measures from the Dental Visit and Visit 3 were funded by the Clinical and Translational Science Institute?s (CTSI?s) Strategic Opportunities Support (SOS) Program RAS Award ID# A117088.

Funding Information:
We thank the participants and staff of the MrOS study. V.G. was supported by grant 1K23DK093710-01A1 from the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) and by the Harold Amos Medical Faculty Development Program of the Robert Wood Johnson Foundation. This project was supported by the National Center for Advancing Translational Sciences, National Institutes of Health, through UCSF-CTSI Grant Number TL1TR000144. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. The MrOS study is supported by National Institutes of Health funding. The following institutes provide support: the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the National Institute on Aging (NIA), the National Center for Research Resources (NCRR) and NIH Roadmap for Medical Research under the following grant numbers: U01 AR45580, U01 AR45614, U01 AR45632, U01 AR45647, U01 AR45654, U01 AR45583, U01 AG18197, U01 AG027810 and UL1 TR000128. The National Institute for Dental and Craniofacial Research (NIDCR) provides funding for the MrOS Dental ancillary study ‘Oral and Skeletal Bone Loss in Older Men’ under the Grant Number R01 DE014386. Cystatin C measures from the Dental Visit and Visit 3 were funded by the Clinical and Translational Science Institute’s (CTSI’s) Strategic Opportunities Support (SOS) Program RAS Award ID# A117088.

Publisher Copyright:
© The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA.

Keywords

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

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