The influence of chronic periodontitis on serum TNF-alpha, IL-6 and hs-CRP concentrations, and function of graft and survival of kidney transplant recipients

Abstract

Objective: The aim of the study is to analyze whether chronic periodontitis (CP) influences serum tumor necrosis factor (TNF)-alpha, interleukin (IL)-6, and high-sensitivity C-reactive protein (hs-CRP) concentrations in renal transplant recipients and patients or graft survival.

Background: CP is associated both with higher serum concentrations of cytokines and CRP and high cardiovascular risk.

Methods: One hundred and seventeen patients with a transplanted kidney (Tx) were divided according to the Community Periodontal Index of Treatment Needs (CPITN) into two subgroups: TxP+: severe CP (CPITN 3-4) and TxP-: no or moderate CP (CPITN 0-2). The control group (C) consisted of 36 subjects with no kidney disease and with no or moderate CP (CPITN 0-2).

Results: hs-CRP concentration was higher in TxP+ than in TxP- patients [2.0 mg/L (0.7-4.4) vs. 0.9 mg/L (0.3-1.9), p = 0.006]. There were no differences in serum TNF-alpha and IL-6 between TxP+ and TxP-. Significant positive correlation between CPITN score and hs-CRP concentration was found both in Tx and C. The hazard ratio of death was 7.17 (1.4-76.4) for TxP+ patients. CP status did not increase the risk of graft loss or doubling of serum creatinine.

Conclusions: Severe CP is associated with increased serum hs-CRP concentration in patients after kidney transplantation. Severe periodontitis seems to increase the risk of patients' death after kidney transplantation.