PERIODONTAL PATHOLOGY AND CHRONIC KIDNEY DISEASE: SYSTEMATIC REVIEW OF THE LITERATURE

Abstract

Background: Chronic Kidney Disease (CKD) contributes to elevated levels of low-grade systemic inflammation (LGSI), which is characterized by the production of inflammatory mediators such as C-reactive protein (CRP) or interleukin-6 (IL-6). These biomarkers reflect the patient's inflammatory status. LGSI can both influence and be influenced by the development of CKD, as well as by other systemic pathologies, including Periodontal Disease (PD). This review aimed to explore the potential bidirectional relationship between CKD and PD in the context of inflammatory biomarkers and to assess whether periodontal treatment can lead to improvements in systemic inflammatory status.
Material and Methods: This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. An electronic search was carried out in the PubMed, Scopus, and Cochrane databases, supplemented by manual cluster searching. The review included randomized clinical trials (RCTs) that employed non-surgical periodontal treatment (NSPT), as well as observational case-control and cross-sectional studies, published in English or Spanish within the past 10 years. The quality of the included studies was assessed using
the Cochrane Risk of Bias and the Newcastle-Ottawa Scale.
Results: A total of five clinical trials, three case-control studies, and seven cross-sectional studies were included in the review. These were summarized in tables that distinguished between patient groups, analyzed biomarkers, and assessed clinical periodontal and renal parameters. Additional information, such as sample type, sex, age, and, in the case of the clinical trials, the type of treatment administered, was also taken into account.
Conclusions: Patients affected by both CKD and PD exhibit heightened systematic inflammation. The findings suggest a relationship between the two conditions, as NSPT appears to reduce inflammatory biomarkers and lead to clinical improvements in both conditions. However, the bidirectional nature of this relationship cannot be confirmed due to insufficient evidence regarding the impact of CKD treatment on periodontal outcomes.