The effect of periodontal disease treatment in patients with continuous ambulatory peritoneal dialysis

Abstract

Purpose: Chronic inflammation is an obvious risk factor of atherosclerotic diseases, and the presence of periodontal disease is one of the important sources of chronic inflammation in patients with chronic kidney disease (CKD) and diabetes mellitus (DM). Thus, we aimed to investigate the effects of non-surgical periodontal therapy of the patients undergoing CAPD due to diabetic nephropathy, diabetic patients without CKD, and healthy controls on inflammation exponents.

Methods: Thirty-two CAPD patients due to diabetic nephropathy (group III), 31 diabetic patients without nephropathy (group II), and 38 healthy subjects (group I) were enrolled to the study. All patients enrolled to the study (to all groups) suffered from chronic periodontitis. Plaque index, Gingival index, pocket depth (PD) measurements were recorded before and after periodontal therapy. All blood samples for biochemical parameters were measured by using standard laboratory techniques with an automatic analyser. Blood samples for TNF-α, IL-6, and PTX-3 were centrifuged, and separated serum and plasma samples were stored at - 80 °C until analysis.

Results: All inflammatory markers were significantly higher in group III than the other two at baseline. TNF-α levels were significantly decreased after periodontal treatment at 3-month visit in all groups. PTX-3, IL-6, and Hs-CRP levels were significantly reduced after periodontal treatment at 3 months in group III.

Conclusion: Periodontal disease is an important source of inflammation in diabetic CAPD patients and treatment of periodontal disease can be monitored by inflammatory markers including TNF-alpha, PTX-3, IL-6, and Hs-CRP. TNF-alpha may be useful and more sensitive monitoring inflammation in healthy patients and diabetic patients after periodontal treatment.

Keywords: Inflammation; Periodontal disease; Periodontal treatment; Peritoneal dialysis.