Periodontitis — an infection of the gums that destroys the tissue and bone supporting the teeth — is associated with the development of kidney disease and end-state renal disease (ESRD) in patients with type 2 diabetes, doctors report. Dr. Wendy A. Shultis, of the National Institutes of Health, Phoenix, Arizona, and studied 529 type 2 diabetics living in the Gila River Indian Community who were at least 25 years of age and had at least one periodontal examination.
Of the 529 subjects in the study, 107 (20 percent) had none/mild periodontitis, 200 (38 percent) had moderate periodontitis, and 117 (22 percent) had severe periodontitis, and 105 subjects (20 percent) were toothless at the start of the study.
A total of 193 subjects showed signs of kidney disease, within a median follow-up period of 9.4 years. During a median follow-up of 14.9 years, 68 subjects developed full-blown renal disease.
Moderate and severe periodontitis and toothlessness predicted the development of kidney disease a dose-dependent manner. In adjusted analyses, people with moderate gum disease had a 2-fold increased risk of kidney disease and those with severe gum disease had a 2.1-fold increased risk. Toothless participants had a 2.6-fold increased risk of developing kidney disease.
Periodontitis also predicted the development of "end-stage renal disease."
A proposed mechanism for the effect of gum disease on the development of kidney disease is inflammation, Shultis and colleagues explain.
"Both periodontitis and kidney disease are associated with inflammatory markers such as C-reactive protein," they explain, "and chronic low-level inflammation associated with periodontitis may lead to endothelial dysfunction, which plays a role in the pathogenesis of kidney disease."
Diabetes Care February 2007.
Learn about the ONlY Instant Disposable In Office A1c Test: Studies have shown that by providing the A1c test in the office while the patient is present, can lower A1c by a full point. Learn about the only 99% accurate disposable A1c test that is CLIA waived and cost less then 10 dollars and reimbursed at least 21 dollars. http://www.a1ctest.com
Help us keep this newsletter free—update your profile!!!!!!!!!!!!!!!!!!!!!!