Chronic kidney disease is widespread and often undiagnosed. Estimates of its prevalence in the U.S. population are as high as 13%. The National Kidney Foundation describes 5 stages, from mild impairment to kidney failure requiring dialysis or transplant. Early detection and treatment can prevent progression of the disease to this stage in many cases. But in up to 75% of chronic kidney disease cases, the patient has no warning until drastic treatment measures are necessary.
Early warning signs of kidney dysfunction could improve the lives of millions of Americans. A research group at Case Western Reserve University hypothesized that periodontal (gum) disease could be one of the red flags. The systemic inflammatory response of the body to gum disease is associated with changes in several medical conditions, including heart disease, osteoporosis, diabetes, respiratory conditions, and pregnancy. See
The Case Western researchers studied 12,947 adults from the Third National Health and Nutrition Examination Survey. They found that subjects with periodontal disease were twice as likely to have chronic kidney disease as subjects with healthy gums, after adjusting for other traditional and non-traditional risk factors.
Periodontal disease was defined for this study as one or more sites with a loss of attachment of at least 4 mm and bleeding on the same tooth. In the most severe cases, the patient loses all his or her natural teeth, and is then defined as edentulous.
The risk for chronic kidney failure is greater for more severe cases of periodontal disease, independent of the person's overall health. The mechanism for this association is not completely understood, but the results are clear. Kidney failure is a major concern for both public health issues and individual quality of life. Any tool we can use to identify individuals at risk has potential to reduce the numbers of dialysis and transplant patients.
by Linda Fugate, Ph.D.
1. Fisher MA, Taylor GW, Shelton BJ, Jamerson KA, Rahman M, Ojo AO, Sehgal AR, “Periodontal disease and other nontraditional risk factors for CKD”, Am J Kidney Dis. 2008 Jan; 51(1):45-52.
2. Fisher MA, Taylor GW. “A prediction model for chronic kidney disease includes periodontal disease”, J Periodontol 2009 Jan;80(1):16-23.
3. Fox CH, Voleti V, Khan LS, Murray B, Vassalotti J. “A quick guide to evidence-based chronic kidney disease care for the primary care physician”, Postgrad Med. 2008 Jul 31;120(2)E01-6.