Periodontal treatment reduces chronic systemic inflammation in peritoneal dialysis patients

Ther Apher Dial. 2014 Jun;18(3):305-8. doi: 10.1111/1744-9987.12105. Epub 2013 Sep 30.


Chronic systemic inflammation, a non traditional risk factor of cardiovascular diseases, is associated with increasing mortality in chronic kidney disease, especially peritoneal dialysis patients. Periodontitis is a potential treatable source of systemic inflammation in peritoneal dialysis patients. Clinical periodontal status was evaluated in 32 stable chronic peritoneal dialysis patients by plaque index and periodontal disease index. Hematologic, blood chemical, nutritional, and dialysis-related data as well as highly sensitive C-reactive protein were analyzed before and after periodontal treatment. At baseline, high sensitive C-reactive protein positively correlated with the clinical periodontal status (plaque index; r = 0.57, P < 0.01, periodontal disease index; r = 0.56, P < 0.01). After completion of periodontal therapy, clinical periodontal indexes were significantly lower and high sensitivity C-reactive protein significantly decreased from 2.93 to 2.21 mg/L. Moreover, blood urea nitrogen increased from 47.33 to 51.8 mg/dL, reflecting nutritional status improvement. Erythropoietin dosage requirement decreased from 8000 to 6000 units/week while hemoglobin level was stable. Periodontitis is an important source of chronic systemic inflammation in peritoneal dialysis patients. Treatment of periodontal diseases can improve systemic inflammation, nutritional status and erythropoietin responsiveness in peritoneal dialysis patients.

Keywords: Inflammation; Periodontitis; Peritoneal dialysis.

MeSH terms

  • Adult
  • Aged
  • Blood Urea Nitrogen
  • C-Reactive Protein / metabolism
  • Dose-Response Relationship, Drug
  • Erythropoietin / administration & dosage
  • Erythropoietin / therapeutic use
  • Female
  • Humans
  • Inflammation / etiology
  • Inflammation / pathology*
  • Kidney Failure, Chronic / therapy*
  • Male
  • Middle Aged
  • Nutritional Status
  • Periodontal Index
  • Periodontitis / pathology
  • Periodontitis / therapy*
  • Peritoneal Dialysis*


  • Erythropoietin
  • C-Reactive Protein