Does periodontal disease reflect atherosclerosis in continuous ambulatory peritoneal dialysis patients?

Background: Chronic infection and inflammation, including periodontitis, are linked to an increased risk for atherosclerosis. To investigate the possible adverse effects of periodontitis in continuous ambulatory peritoneal dialysis (CAPD) patients, we compared periodontal severity with inflammation and malnutrition, which are associated with poor atherosclerotic outcome in CAPD patients.

Methods: A total of 110 CAPD patients were included in this study to evaluate their clinical periodontal status by using the plaque index, gingival index, and periodontal disease index. Values for nutritional and inflammatory markers and atherosclerotic risk factors were included for analysis with the periodontal index. Analysis of variance, post hoc Tukey's honestly significant difference, univariate and multivariate linear regression analysis, Pearson correlation analysis, and chi2 analysis were used in the evaluation of the data.

Results: Poor oral health status was exhibited by 85.5% of our CAPD patients with periodontal disease. We found that age and longer dialysis duration were associated with the severity of periodontitis. Parameters of malnutrition and inflammation and atherosclerotic risk factors also were associated with poor periodontal status. We carried out multiple regression analysis and found that age, albumin level, and duration of dialysis were associated independently with the severity of periodontitis in CAPD patients. A higher percentage of patients in the severe periodontitis group had malnutrition (chi2 = 59.4; P < 0.001), inflammation (chi2 = 60; P < 0.001), and atherosclerosis (chi2 = 65.6; P < 0.001).

Conclusions: Periodontal health is poor in CAPD patients and correlates with markers of malnutrition, inflammation, and atherosclerosis. The diagnosis and treatment of periodontal diseases require better awareness.