+1 Recommend
1 collections
      • Record: found
      • Abstract: found
      • Article: found

      Periodontitis Is an Important and Occult Source of Inflammation in Hemodialysis Patients

      Read this article at

          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.


          Aim: To evaluate the association between C-reactive protein (CRP) levels and the periodontal status of hemodialysis (HD) patients. Methods: 41 HD patients on rHuEPO therapy were enrolled in the study. Hematologic and biochemical parameters and CRP levels were recorded. The plaque index, gingival index, probing pocket depth and periodontal disease index were used to identify periodontal disease. The patients were divided into 2 groups: group 1 (n = 21), high CRP, and group 2 (n = 20), normal CRP. Results: After periodontal therapy, while the mean CRP level and erythrocyte sedimentation rate declined from 30.46 to 10.36 (p = 0.001) and from 93.4 to 35.8 mg/l (p = 0.001), respectively, the hemoglobin level increased from 9.4 to 10.6 g/dl (p = 0.009) and hematocrit level from 28.2 to 32.0% (p = 0.008) in group 1. Conclusion: Periodontitis is an important and occult source of chronic inflammation and increases the CRP levels in HD patients. Periodontitis can cause hyporesponsiveness to rHuEPO treatment and decrease the hemoglobin levels.

          Related collections

          Most cited references 5

          • Record: found
          • Abstract: not found
          • Article: not found

          Periodontitis and Systemic Inflammation: Control of the Local Infection is Associated with a Reduction in Serum Inflammatory Markers

            • Record: found
            • Abstract: found
            • Article: not found

            Serum markers of periodontal disease status and inflammation in hemodialysis patients.

            Hemodialysis (HD) patients face a 25% annual mortality rate, with 50% of reported deaths attributed to cardiovascular disease. All-cause and cardiovascular mortality correlate with such acute-phase proteins as C-reactive protein (CRP). Hepatic CRP synthesis is upregulated by inflammation; however, elevated CRP values frequently are found in the absence of apparent infection or inflammation. Because destructive periodontal diseases have been associated with elevated CRP levels, we questioned whether destructive periodontal diseases could contribute to elevated CRP values in HD populations. Sera from 86 consecutive dentate HD patients were assayed for levels of immunoglobulin G (IgG) antibody to six periodontal species by means of an enzyme-linked immunosorbent assay. CRP values for the subject population ranged from less than 6.9 to 159 mg/L (median, 8.2 mg/L). Univariate comparisons between subjects with or without elevated CRP levels (>10 mg/L) showed that CRP level elevation was associated significantly (P < 0.05) with greater doses of human recombinant erythropoietin and lower levels of hemoglobin, serum iron, transferrin saturation (TSat), albumin averaged over the 3 preceding months, total cholesterol, and triglycerides. Log serum IgG antibody levels to Porphyromonas gingivalis also were significantly greater in the group with elevated CRP levels (P = 0.013). Subsequent multivariate logistic regression showed that log serum antibody levels to P gingivalis remained significant (P = 0.02) after controlling for nonperiodontal sources of elevated CRP, hemoglobin, TSat, and triglyceride values. These results suggest that elevated levels of IgG antibody to bacterial species associated with destructive periodontal diseases are associated with elevated CRP values in HD populations. Copyright 2002 by the National Kidney Foundation, Inc.
              • Record: found
              • Abstract: found
              • Article: not found

              Antimicrobial periodontal treatment decreases serum C-reactive protein, tumor necrosis factor-alpha, but not adiponectin levels in patients with chronic periodontitis.

              Elevated levels of C-reactive protein (CRP) and decreased plasma adiponectin are associated with increased risk of atherosclerosis. Furthermore, recent observations suggested that adiponectin and tumor necrosis factor-alpha (TNF-alpha) suppressed each other's production. Since periodontal disease has been suggested to act as a risk factor for atherosclerosis, we examined the effects of antimicrobial periodontal treatment on CRP, adiponectin, and TNF-alpha levels. Fifteen chronic periodontitis patients with various systemic conditions at high risk for atherosclerosis were enrolled in the study. Patients were non-surgically treated with topical application of antibiotics and mechanical debridement of calculus once a week for 1 month. Before and after therapy, CRP, adiponectin, and TNF-alpha levels were measured. Both CRP and TNF-alpha levels were significantly decreased after treatment (P<0.01 and P<0.03, respectively), while adiponectin levels did not change significantly. Periodontal treatment is effective in reducing CRP and TNF-alpha, while adiponectin does not appear to be influenced by periodontal treatment. Elevated levels of CRP and TNF-alpha may be associated with increased risk for future development of atherosclerosis in periodontitis patients.

                Author and article information

                Blood Purif
                Blood Purification
                S. Karger AG
                August 2006
                14 August 2006
                : 24
                : 4
                : 400-404
                aDepartment of Nephrology, Medical Faculty, and bDepartment of Periodontology, Dental Faculty, University of Dicle, Diyarbakir, Turkey
                93683 Blood Purif 2006;24:400–404
                © 2006 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Figures: 1, Tables: 5, References: 20, Pages: 5
                Self URI (application/pdf): https://www.karger.com/Article/Pdf/93683
                Original Paper


                Comment on this article