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Meta-Analysis
. 2020 Jan 22;20(1):18.
doi: 10.1186/s12903-020-1004-1.

Effects of non-surgical periodontal therapy on systemic inflammation and metabolic markers in patients undergoing haemodialysis and/or peritoneal dialysis: a systematic review and meta-analysis

Hui Yue  1 , Xinxin Xu  2   3   4 , Qin Liu  5 , Xiaozhi Li  1 , Yiting Xiao  1 , Bo Hu  6   7   8
Affiliations
Meta-Analysis

Effects of non-surgical periodontal therapy on systemic inflammation and metabolic markers in patients undergoing haemodialysis and/or peritoneal dialysis: a systematic review and meta-analysis

Hui Yue et al. BMC Oral Health. .

Abstract

Background: This systematic review aimed to investigate whether non-surgical periodontal therapy (NSPT) can reduce systemic inflammatory levels and improve metabolism in patients undergoing haemodialysis (HD) and/or peritoneal dialysis (PD).

Methods: Electronic databases (PubMed, EMBASE, CENTRAL, CNKI, and WFPD) were searched for randomized controlled trials (RCTs) performed through July 2019. The risk of bias within studies was assessed with the Cochrane Collaboration's risk assessment tool. The systemic inflammatory and metabolic outcomes included the highly sensitive C-reactive protein (hs-CRP), interleukin 6 (IL-6), tumour necrosis factor-a (TNF-a), the albumin (Alb), and lipid metabolite levels. Meta-analyses (MAs) were performed to calculate the overall effect size where appropriate.

Results: Five RCTs were included in this study. Compared with untreated periodontitis groups, the dialysis patients after NSPT significantly showed decreased hs-CRP levels at less than or equal to 2 months (standardized mean difference: - 1.53, 95% confidence interval - 2.95 to - 0.11). No significant difference was found in IL-6 and Alb levels following NSPT at either the 3- or 6- month follow-ups. No MAs could be performed on the TNF-a level and the lipid metabolic markers.

Conclusions: NSPT can moderately reduce serum hs-CRP levels in HD and/or PD patients, but did not significantly change IL-6 or Alb levels. For TNF-a and lipid metabolism markers, no sufficient evidence supports that these levels are changed after NSPT. Additional scientific research is necessary to assess the effects of NSPT on systemic inflammation and metabolic parameters in dialysis patients.

Keywords: End-stage renal disease; Haemodialysis; Non-surgical periodontal treatment; Peritoneal dialysis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of the studies identified, included, and excluded
Fig. 2
Fig. 2
Forest plot of the difference between serum c-reactive protein intervention and control patients at less than or equal to 2 months. ES: effect size
Fig. 3
Fig. 3
Forest plot of the difference between interleukin 6 intervention and control patients at 3 months and 6 months. ES: effect size
Fig. 4
Fig. 4
Forest plot of the difference between albumin intervention and control patients at 3 months and 6 months.ES: effect size
See this image and copyright information in PMC

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