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Effect of non-surgical periodontal therapy on renal function in chronic kidney disease patients with periodontitis: a systematic review and meta-analysis of interventional studies

  • Dan Zhao
  • Abrar Tahir Khawaja
  • Lijian Jin
  • Kam Wa Chan
  • Maurizio Tonetti
  • Sydney Chi Wai Tang
  • George PelekosEmail author
Original Article

Abstract

Objective

This systematic review evaluated the impacts of non-surgical periodontal therapy (NSPT) in patients with chronic kidney disease (CKD) and periodontitis in order to explore causality and assess the potential benefits of co-management.

Methods

This systematic review and meta-analyses were conducted by searching MEDLINE, EMBASE, PubMed, Cochrane Library, and Open GREY. Interventional studies of adult patients suffering from CKD and periodontitis were investigated. Effect of NSPT on renal function was analyzed.

Results

A total of 109 participants from four case-series studies and 97 participants from one randomized controlled trial were included in this review. Sixty percent of the eligible studies (3/5) aimed at the effect of NSPT on nutritional status and systemic inflammation in dialysis patients. The other two studies concluded a beneficial impact of NSPT on estimated glomerular filtration rate (eGFR) in patients with CKD stages 2–4. Moreover, two meta-analyses were accomplished on eGFR and serum creatinine to evaluate the changes between baseline and 3-month follow-up. The pooled mean of eGFR was not significantly different pre- and post-NSPT using random and fixed-effect models. The change for creatinine was not significant using the random effect model but was significant when the fixed effect model was used (p < 0.001).

Conclusions

There is insufficient evidence to conclude the potential benefit of NSPT on renal function in CKD patients with periodontitis.

Clinical relevance

Periodontitis contributes to the inflammatory burden and has been associated with impaired kidney function in many observational studies. However, well-designed clinical trials in pre-dialysis patients investigating the impact of NSPT on renal function–related parameters are missing.

Keywords

Chronic kidney disease Renal function Periodontitis Non-surgical periodontal therapy Systematic review Meta-analysis 

Notes

Funding information

This review was supported by The University of Hong Kong, Hong Kong SAR, China.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study, formal consent is not required.

Supplementary material

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Periodontology, Faculty of DentistryThe University of Hong KongHong KongChina
  2. 2.Department of Medicine, Li Ka Shing Faculty of MedicineThe University of Hong KongHong KongChina

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