Effect of chronic kidney disease on progression of clinical attachment loss in older adults: A 4-year cohort study

Abstract

Background: People with chronic kidney disease (CKD) may have an increased risk of periodontal disease, but longitudinal evidence is sparse.

Methods: This 4-year cohort study assessed the association between CKD and changes in periodontal health status, defined by attachment loss (AL) progression, among older adults. Participants were 388 community-dwelling Japanese adults who were 70 years old at baseline with 7053 teeth. Estimated glomerular filtration rate (eGFR) was calculated by using baseline serum creatinine concentration. AL at six sites for every tooth was recorded at baseline and follow-up examinations. Multilevel logistic regression models estimated the tooth-specific risk of AL progression (≥1 site exhibiting a ≥3 mm increase in AL) with baseline CKD (eGFR < 60 mL/min/1.73 m² ) as the principal exposure.

Results: At baseline, 27.8% of the study population (108/388 participants) had CKD. After 4 years, 21.8% of the studied teeth (1537/7053 teeth) exhibited AL progression. After applying inverse probability weighting and adjusting for potential confounders, including sex, use of devices for interdental cleaning, smoking, diabetes, tooth location, abutment for a removable denture, and highest AL, CKD was associated with significantly higher odds of AL progression (adjusted odds ratio: 1.73; 95% confidence interval: 1.15-2.60).

Conclusions: The results suggest that CKD increases the risk of periodontal disease progression in older community-dwelling Japanese adults. Additional studies with more complete information, as well as in other geographic areas and age groups, are necessary to further generalize the findings.

Keywords: aged; epidemiology; oral health; periodontal diseases; renal insufficiency.