Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan 5;18(1):326.
doi: 10.3390/ijerph18010326.

Investigation of the Impact of Endodontic Therapy on Survival among Dialysis Patients in Taiwan: A Nationwide Population-Based Cohort Study

Chih-Chien Chiu  1   2 , Ya-Chieh Chang  3   4 , Ren-Yeong Huang  5 , Jenq-Shyong Chan  3   4 , Chi-Hsiang Chung  6 , Wu-Chien Chien  6   7 , Yung-Hsi Kao  8 , Po-Jen Hsiao  3   4   8
Affiliations

Investigation of the Impact of Endodontic Therapy on Survival among Dialysis Patients in Taiwan: A Nationwide Population-Based Cohort Study

Chih-Chien Chiu et al. Int J Environ Res Public Health. .

Abstract

Objectives Dental problems occur widely in patients with chronic kidney disease (CKD) and may increase comorbidities. Root canal therapy (RCT) is a common procedure for advanced decayed caries with pulp inflammation and root canals. However, end-stage renal disease (ESRD) patients are considered to have a higher risk of potentially life-threatening infections after treatment and might fail to receive satisfactory dental care such as RCT. We investigated whether appropriate intervention for dental problems had a potential impact among dialysis patients. Design Men and women who began maintenance dialysis (hemodialysis or peritoneal dialysis) between January 1, 2000, and December 31, 2015, in Taiwan (total 12,454 patients) were enrolled in this study. Participants were followed up from the first reported dialysis date to the date of death or end of dialysis by December 31, 2015. Setting Data collection was conducted in Taiwan. Results A total of 2633 and 9821 patients were classified into the RCT and non-RCT groups, respectively. From the data of Taiwan's National Health Insurance, a total of 5,092,734 teeth received RCT from 2000 to 2015. Then, a total of 12,454 patients were followed within the 16 years, and 4030 patients passed away. The results showed that members of the non-RCT group (34.93%) had a higher mortality rate than those of the RCT group (22.79%; p = 0.001). The multivariate-adjusted hazard ratio for the risk of death was 0.69 (RCT vs. non-RCT; p = 0.001). Conclusions This study suggested that patients who had received RCT had a relatively lower risk of death among dialysis patients. Infectious diseases had a significant role in mortality among dialysis patients with non-RCT. Appropriate interventions for dental problems may increase survival among dialysis patients. Abbreviations: CKD = chronic kidney disease, ESRD = end-stage renal disease, RCT = root canal therapy.

Keywords: dialysis; end-stage renal disease; root canal therapy; survival.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
The retrospective cohort study flow diagram.
Figure 2
Figure 2
Cumulative survival in dialysis patients with RCT compared to without RCT. The cohort study was followed up for 16 years.
See this image and copyright information in PMC

References

    1. 2019 USRDS Annual Data Report. Volume 2: ESRD in the United States. Chapter 11: International Comparisons. [(accessed on 31 December 2020)]; Available online: https://www.usrds.org/annual-data-report/previous-adrs/
    1. Tsai S.Y., Tseng H.F., Tan H.F., Chien Y.S., Chang C.C. End-stage renal disease in Taiwan: A case-control study. J. Epidemiol. 2009;19:169–176. doi: 10.2188/jea.JE20080099. - DOI - PMC - PubMed
    1. Bello A.K., Alrukhaimi M., Ashuntantang G.E., Basnet S., Rotter R.C., Douthat W.G., Kazancioglu R., Köttgen A., Nangaku M., Powe N.R., et al. Complications of chronic kidney disease: Current state, knowledge gaps, and strategy for action. Kidney Int. Suppl. 2017;7:122–129. doi: 10.1016/j.kisu.2017.07.007. - DOI - PMC - PubMed
    1. Vogelzang J.L., van Stralen K.J., Noordzij M., Diez J.A., Carrero J.J., Couchoud C., Dekker F.W., Finne P., Fouque D., Heaf J.G., et al. Mortality from infections and malignancies in patients treated with renal replacement therapy: Data from the ERA-EDTA registry. Nephrol. Dial. Transpl. 2015;30:1028–1037. doi: 10.1093/ndt/gfv007. - DOI - PubMed
    1. Al Wakeel J.S., Mitwalli A.H., Al Mohaya S., Abu-Aisha H., Tarif N., Malik G.H., Hammad D. Morbidity and mortality in ESRD patients on dialysis. Saudi J. Kidney Dis. Transpl. 2002;13:473–477. - PubMed

Publication types

LinkOut - more resources