I had no idea poor dental health had a detrimental effect on CKD. As
one who tends to avoid the dentist at all costs its a bit of a
shocker.
http://www.medpagetoday.com/MeetingCoverage/NKF/26213
NKF: CKD Patients Often Dodge the Dentist
By Ed Susman, Contributing Writer, MedPage Today
Published: May 01, 2011
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of
Medicine, University of California, San Francisco and Dorothy Caputo,
MA, RN, BC-ADM, CDE, Nurse Planner
Take Posttest
Action Points
Note that this study was published as an abstract and presented at a
conference. These data and conclusions should be considered to be
preliminary until published in a peer-reviewed journal.
Explain that patients with chronic kidney disease were less likely to
visit the dentist than those without the disease.
LAS VEGAS -- Patients with chronic kidney disease were less likely to
visit the dentist, possibly increasing the burden of their disease,
researchers reported at the National Kidney Foundation Spring Clinical
Meetings.
Previous studies have shown a correlation between periodontal disease
and CKD, said Vanessa Grubbs, MD, assistant professor of medicine at
San Francisco General Hospital and the University of California at San
Francisco. Maintaining dental health through regular dental visits may
play a vital role in reducing the burden of the inflammatory disease
process.
Grubbs and colleagues found that patients with CKD were 58% less
likely [OR=0.42, 95% CI (0.33 to 0.53)] than patients without CKD to
have visited the dentist during four years follow-up.
"We have identified a group of people who have a lot of chronic kidney
disease and they don't go to the dentist," she told MedPage Today.
"This may be a missed opportunity because, if they went to the
dentist, at least someone is taking care of their mouth and they get
rid of that chronic inflammatory burden."
Grubbs and colleagues scrutinized the records of 6,484 patients
randomly selected from the San Francisco Department of Public Health
Community Health Network. They included patients with at least one
year of follow-up, but overall, the cohort had about 4.5 years of
follow-up between January 2005 and May 2010, she said. They identified
2,235 patients (34.5%) with CKD, which they defined as an average
glomerular filtration rate of less than 60 ml/min/1.73m2.
Of all the patients included in the study, 500 (7.7%) had seen a
dentist at least once during the follow-up period, Grubbs reported.
Ninety-four (4.2%) patients with CKD had paid a visit to the dentist
versus 405 (9.5%) of the 4,249 of the patients without kidney disease.
When the researchers looked at different ethnic groups in the overall
patient population, African Americans and Hispanics were more likely
to have visited a dentist than Caucasians. African Americans were 2.5
times more likely to have seen a dentist than Caucasians; Hispanics
were 2.1 times more likely to have seen a dentist than Caucasians.
However, African Americans with chronic kidney disease were 46% less
likely to have seen a dentist than blacks without CKD. Hispanics with
CKD were 50% less likely to have seen a dental professional than
Hispanics who did not have CKD.
Grubbs said she uncovered this preliminary data as part of her
research on the potential link between periodontal disease and CKD.
"It is an interesting observation that periodontitis is an example of
a chronic inflammatory disease that may have a negative impact on
kidney function over the long term," commented Jeffrey Berns, MD,
associate chief of renal, electrolyte, and hypertension division of
the Perelman Center for Advanced Medicine at the University of
Pennsylvania in Philadelphia.
Berns told MedPage Today that current medical literature contains
reports that link periodontal disease and kidney disease. "There is
the feeling that having any chronic inflammatory disease – dental
disease being a good example of one – might confer some risk due to
inflammatory chemicals in the bloodstream. Periodontitis would be
something that is a low-grade chronic inflammation that people may not
attend to, but clearly is associated with inflammatory response," he
said.
"It's a complicated issue. There are ethnic issues and access to care
issues," Berns also noted.
Grubbs had no disclosures.
Berns disclosed financial relationships with Amgen, Wyeth, Litholink,
and Affymax.
Primary source: National Kidney Foundation
Source reference:
Grubbs V, et al "Missed opportunity? -- Dental visits by chronic
kidney disease status in underserved patients" NKF 2011; Abstract 73.