Association between dental and periodontal conditions with chronic kidney disease: A cross-sectional analysis of urban South Africans

Authors

DOI:

https://doi.org/10.17159/2519-0105/2022/v77no1a1

Keywords:

Chronic kidney disease; oral disease; periodontitis; dental; tooth loss; Africa

Abstract

Oral diseases are preventable causes of poor health outcomes in people with chronic kidney disease (CKD). Investigate the association between dental and periodontal conditions with kidney function and determine whether inflammation mediate the association between periodontitis and CKD. Cross-sectional analysis of 1551 South African adults of mixed ancestry. CKD was classified as estimated glomerular filtration rate (eGFR) <60mL/min/1.73m2. Oral profile was captured by decayed, missing, filled teeth index (DMFTi), bleeding on probing (BOP), pocket depth (PD), clinical attachment loss (CAL), and periodontitis classified as PD ≥4 mm.
Overall, 6% had CKD, with 93% and 66% of participants with and without CKD, respectively having a high DMFTi (p<0.0001). Further, 84% (CKD) and 43% (without CKD) were edentulous (p<0.0001). A great proportion of the dentate sub-sample (n=846) had periodontitis, however, BOP, PD ≥4mm and CAL ≥4mm were similar between the groups. DMFTi was associated with eGFR and prevalent CKD (p<0.023), with this association driven by the Missing component. Periodontitis was not associated with eGFR
nor CKD (p>0.282). In routine care of people with CKD, attention should be given to oral health.

Downloads

Download data is not yet available.

Author Biography

Andre P Kengne, South Africa and Department of Medicine, University of Cape Town, Cape Town, South Africa






References

Eckardt KU, Coresh J, Devuyst O, Johnson RJ, Kottgen A, Levey AS, Levin A. Evolving importance of kidney disease: from subspecialty to global health burden. Lancet. 2013;382(9887):158-69. doi: 10.1016/S0140- 6736(13)60439-0.

George C, Mogueo A, Okpechi I, Echouffo-Tcheugui JB, Kengne AP. Chronic kidney disease in low-income to middle-income countries: the case for increased screening. BMJ Glob Health. 2017;2(2):e000256. doi: 10.1136/bmjgh-2016-000256.

Kaze AD, Ilori T, Jaar BG, Echouffo-Tcheugui JB. Burden of chronic kidney disease on the African continent: a systematic review and meta-analysis. BMC Nephrol. 2018;19(1):125. doi: 10.1186/s12882-018-0930-5

Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, Ndiaye C. The global burden of oral diseases and risks to oral health. Bulletin of the World Health Organization. 2005;83(9):661-9.

Global Burden of Disease 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the

Global Burden of Disease Study 2016. Lancet (London, England). 2017;390(10100):1211-59. doi: 10.1016/S0140-6736(17)32154-2.

Deschamps-Lenhardt S, Martin-Cabezas R, Hannedouche T, Huck O. Association between periodontitis and chronic kidney disease: Systematic review and meta-analysis. Oral diseases. 2019;25(2):385-402. doi: 10.1111/odi.12834.

Ioannidou E, Swede H, Dongari-Bagtzoglou A. Periodontitis predicts elevated C-reactive protein levels in chronic kidney disease. Journal of dental research. 2011;90(12):1411-5. doi: 10.1177/0022034511423394.

Sharma P, Dietrich T, Ferro CJ, Cockwell P, Chapple IL. Association between periodontitis and mortality in stages 3-5 chronic kidney disease: NHANES III and linked mortality study. Journal of clinical periodontology. 2016;43(2):104-13. doi: 10.1111/jcpe.12502.

Fisher MA, Taylor GW. A prediction model for chronic kidney disease includes periodontal disease. Journal of periodontology. 2009;80(1):16-23. doi: 10.1902/jop.2009.080226.

Peres MA, Macpherson LMD, Weyant RJ, Daly B, Venturelli R, Mathur MR, Listl S, Celeste RK, GuarnizoHerreño CC, Kearns C, Benzian H, Allison P, Watt RG. Oral diseases: a global public health challenge. Lancet. 2019;394(10194):249-60. doi: 10.1016/S0140-6736(19)31146-8.

Zhao D, Khawaja AT, Jin L, Li KY, Tonetti M, Pelekos G. The directional and non-directional associations of periodontitis with chronic kidney disease: A systematic review and meta-analysis of observational studies. Journal of periodontal research. 2018;53(5):682-704.

doi: 10.1111/jre.12565.

Petersen PE, Ogawa H. The global burden of periodontal disease: towards integration with chronic disease prevention and control. Periodontology 2000. 2012;60(1):15-39. doi: 10.1111/j.1600-0757.2011.00425.x.

Hajishengallis G, Lambris JD. Complement and dysbiosis in periodontal disease. Immunobiology. 2012;217(11):1111-6. doi: 10.1016/j.

imbio.2012.07.007.

D'Aiuto F, Parkar M, Andreou G, Suvan J, Brett PM, Ready D, Tonetti MS. Periodontitis and systemic inflammation: control of the local infection is associated with a reduction in serum inflammatory markers. Journal of dental research. 2004;83(2):156-60. doi:

1177/154405910408300214.

Paraskevas S, Huizinga JD, Loos BG. A systematic review and meta-analyses on C-reactive protein in relation to periodontitis. Journal of

clinical periodontology. 2008;35(4):277-90. doi: 10.1111/j.1600-051X.2007.01173.x.

Borawski J, Wilczyńska-Borawska M, Stokowska W, Myśliwiec M. The periodontal status of pre-dialysis chronic kidney disease and maintenance dialysis patients. Nephrol Dial Transplant. 2007;22(2):457-64. doi: 10.1093/ndt/gfl676.

Ioannidou E, Hall Y, Swede H, Himmelfarb J. Periodontitis associated with chronic kidney disease among Mexican Americans. Journal of public health dentistry. 2013;73(2):112-9. doi: 10.1111/j.1752-7325.2012.00350.x.

Andrade MR, Salazar SL, de Sá LF, Portela M, FerreiraPereira A, Soares RM, Leão AT, Primo LG. Role of saliva in the caries experience and calculus formation of young patients undergoing hemodialysis. Clinical oral investigations. 2015;19(8):1973-80. doi: 10.1007/s00784-015-1441-4.

Menezes CR, Pereira AL, Ribeiro CC, Chaves CO, Guerra RN, Thomaz É B, Monteiro-Neto V, Alves CM. Is there association between chronic kidney disease and dental caries? A case-controlled study. Medicina oral, patologia oral y cirugia bucal. 2019;24(2):e211-e6. doi: 10.4317/medoral.22737.

Thorman R, Neovius M, Hylander B. Clinical findings in oral health during progression of chronic kidney disease to end-stage renal disease in a Swedish population. Scandinavian journal of urology and nephrology. 2009;43(2):154-9. doi: 10.1080/00365590802464817.

Andrade MR, Antunes LA, Soares RM, Leao AT, Maia LC, Primo LG. Lower dental caries prevalence associated to chronic kidney disease: a systematic review. Pediatric nephrology (Berlin, Germany). 2014;29(5):771-8. doi: 10.1007/s00467-013-2437-4.

Garcez J, Limeres Posse J, Carmona IT, Feijoo JF, Diz Dios P. Oral health status of patients with a mild decrease in glomerular filtration rate. Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics. 2009;107(2):224-8. doi: 10.1016/j.tripleo.2008.09.018.

Kengne AP, Erasmus RT, Levitt NS, Matsha TE. Alternative indices of glucose homeostasis as

biochemical diagnostic tests for abnormal glucose tolerance in an African setting. Primary care diabetes. 2017;11(2):119-31

World Health Organization. Oral health surveys: basic methods. 5th ed. Geneva: WHO; 2013.

Chikte U, Pontes CC, Karangwa I, Kimmie-Dhansay F, Erasmus R, Kengne AP, et al. Dental caries in a South African adult population: findings from the Cape Town Vascular and Metabolic Health Study. Int Dent J. 2019:10.1111/idj.12538.

Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Annals of internal medicine.

;130(6):461-70. doi: 10.7326/0003-4819-130-6-199903160-00002.

Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF, 3rd, Feldman HI, Kusek JW, Eggers P, Van Lente F, Greene T, Coresh J, Chronic Kidney Disease Epidemiology Collaboration. A new equation to estimate glomerular filtration rate. Annals of internal medicine. 2009;150(9):604-12. doi: 10.7326/0003-4819-150-9-200905050-00006.

Levey AS, Coresh J, Balk E, Kausz AT, Levin A, Steffes MW, Hogg RJ, Perrone RD, Lau J, Eknoyan G, National Kidney Foundation. National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Annals of internal medicine. 2003;139(2):137-47. doi: 10.7326/0003-4819-139-2-200307150-00013.

World Health Organization. A global brief on Hypertension: Silent killer, global public health crisis. 2013.

World Health Organization, International Diabetes Federation. Definition and diagnosis of diabetes mellitus and intermediate hyperglycaemia: report of a WHO/IDF consultation. Geneva: World Health Organization; 2006.

Tonelli M, Sacks F, Pfeffer M, Jhangri GS, Curhan G, Cholesterol Recurrent Events Trial Investigators. Biomarkers of inflammation and progression of chronic kidney disease. Kidney Int. 2005;68(1):237-45. doi: 10.1111/j.1523-1755.2005.00398.x.

Menon V, Greene T, Wang X, Pereira AA, Marcovina SM, Beck GJ, Kusek JW, Collins AJ, Levey AS, Sarnak MJ. C-reactive protein and albumin as predictors of all-cause and cardiovascular mortality in chronic kidney disease. Kidney Int. 2005;68(2):766-72. doi: 10.1111/j.1523-1755.2005.00455.x.

Akar H, Akar GC, Carrero JJ, Stenvinkel P, Lindholm B. Systemic consequences of poor oral health in chronic kidney disease patients. Clin J Am Soc Nephrol. 2011;6(1):218-26. doi: 10.2215/CJN.05470610.

Grubbs V, Vittinghoff E, Taylor G, Kritz-Silverstein D, Powe N, Bibbins-Domingo K, Ishani A, Cummings SR, Osteoporotic Fractures in Men Study Research Group. The association of periodontal disease with kidney function decline: a longitudinal retrospective analysis of the MrOS dental study. Nephrol Dial Transplant. 2016;31(3):466-72. doi: 10.1093/ndt/gfv312.

Petersen P, World Health Organization Oral Health Programme. The world oral health report 2003: continuous improvement of oral health in the 21st century - the approach of the WHO Global Oral Health Programme. Geneva: World Health Organization; 2003.10 > RESEARCH www.sada.co.za / SADJ Vol. 77 No. 1

South African Department of Health. National Oral Health Survey: South Africa 1988/89. In: Health Do, editor. Pretoria1994.

Ruospo M, Palmer SC, Craig JC, Gentile G, Johnson DW, Ford PJ, Tonelli M, Petruzzi M, De Benedittis M, Strippoli GF. Prevalence and severity of oral disease in adults with chronic kidney disease: a systematic review of observational studies. Nephrol Dial Transplant.

;29(2):364-75. doi: 10.1093/ndt/gft401.

Jepsen S, Blanco J, Buchalla W, Carvalho JC, Dietrich T, Dörfer C, Eaton KA, Figuero E, Frencken JE, Graziani F, Higham SM, Kocher T, Maltz M, Ortiz-Vigon A, Schmoeckel J, Sculean A, Tenuta LM, van der Veen MH, Machiulskiene V. Prevention and control of dental caries

and periodontal diseases at individual and population level: consensus report of group 3 of joint EFP/ORCA workshop on the boundaries between caries and periodontal diseases. Journal of clinical periodontology. 2017;44 Suppl 18:S85-s93. doi: 10.1111/jcpe.12687.

Kassebaum NJ, Bernabé E, Dahiya M, Bhandari B, Murray CJL, Marcenes W. Global Burden of Severe Tooth Loss: A Systematic Review and Meta-analysis. Journal of dental research. 2014;93(7 Suppl):20S-8S. doi: 10.1177/0022034514537828.

Pham TAV, Le DD. Dental condition and salivary characteristics in Vietnamese patients with chronic kidney disease. International journal of dental hygiene. 2019;17(3):253-60. doi: 10.1111/idh.12380.

Grubbs V, Plantinga LC, Tuot DS, Powe NR. Chronic kidney disease and use of dental services in a United

States public healthcare system: a retrospective cohort study. BMC Nephrol. 2012;13(1):16. doi: 0.1186/1471-2369-13-16.

WHO Regional Office for Africa. Promoting Oral Health in Africa: Prevention and control of oral diseases and

noma as part of essential noncommunicable disease interventions. 2016.

Kailembo A, Preet R, Stewart Williams J. Common risk factors and edentulism in adults, aged 50 years and over, in China, Ghana, India and South Africa: results from the WHO Study on global AGEing and adult health (SAGE). BMC oral health. 2016;17(1):29. doi: 10.1186/ s12903-016-0256-2.

van Wyk PJ, van Wyk C. Oral health in South Africa. Int Dent J. 2004;54(6 Suppl 1):373-7. doi: 10.1111/j.1875-595x.2004.tb00014.x.

Molete MP, Yengopal V, Moorman J. Oral health needs and barriers to accessing care among the elderly in Johannesburg. SADJ: journal of the South African Dental Association = tydskrif van die Suid-Afrikaanse Tandheelkundige Vereniging. 2014;69(8):352, 4-7.

Olutola BG, Ayo-Yusuf OA. Socio-environmental factors associated with self-rated oral health in South Africa: a multilevel effects model. International journal of environmental research and public health. 2012;9(10):3465-83. doi: 10.3390/ijerph9103465.

Peltzer K, Hewlett S, Yawson AE, Moynihan P, Preet R, Wu F, Guo G, Arokiasamy P, Snodgrass JJ, Chatterji S, Engelstad ME, Kowal P. Prevalence of loss of all teeth (edentulism) and associated factors in older adults in China, Ghana, India, Mexico, Russia and South Africa. International journal of environmental research and public health. 20

Downloads

Published

2022-03-08

How to Cite

George, C. ., Matsha, T. E. ., Davids, S. F. ., Hon, G. M. ., Chikte, U. ., Erasmus, R. T. ., & Kengne, A. P. (2022). Association between dental and periodontal conditions with chronic kidney disease: A cross-sectional analysis of urban South Africans. South African Dental Journal, 77(01). https://doi.org/10.17159/2519-0105/2022/v77no1a1

Most read articles by the same author(s)