The prevalence of periodontitis was twice as high in those showing early signs of kidney dysfunction in a new study, adding to growing evidence that gum disease should be considered a systemic issue.
Though gum disease has previously been linked to severe kidney failure, researchers from the University Medical Center Hamburg-Eppendorf have now found an association with early renal dysfunction.
While 14% of people present with severe periodontitis, this figure rose to 36% in those with moderately reduced kidney function. More severe gum disease was also associated with albuminuria, or protein in the urine – an early marker of kidney damage.
Cumulative signs of gum disease such as clinical attachment loss and tooth loss were found to worsen as kidney function declined.
This relationship remained despite accounting for related risk factors such as age, sex, smoking and diabetes. This means the association cannot be explained by shared risk factors.
Why does gum disease impact kidney dysfunction?
There are a number of factors that could explain the link between gum disease and kidney dysfunction. Firstly, inflammation in many parts of the body can cause systemic issues elsewhere.
The researchers estimated that around 35% of the association was down to high-sensitivity C-reactive protein entering the bloodstream from gum inflammation. However, this only explained around 10% of the link with albuminuria.
Other mechanisms that could contribute include spread of periodontal bacteria into the bloodstream, endothelial dysfunction, oxidative stress and metabolic changes.
The findings support oral health as a potential indicator of kidney dysfunction. The authors said: ‘Our findings underscore that assessing kidney function is important in individuals with periodontitis.’
They continued: ‘These findings may help inform future screening strategies and provide a rationale for trials investigating whether periodontal treatment can influence the progression of kidney disease.’
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