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Periodontal Diseases Increase C-Reactive Protein In Haemodialysis Patients
A DGReview of :"Serum markers of periodontal disease status and inflammation in hemodialysis patients."
American Journal of Kidney Diseases
11/07/2002
By David Loshak
Elevated levels of immunoglobulin G antibody to bacterial species associated with destructive periodontal diseases are also linked to elevated C-reactive protein values in people who receive haemodialysis.
Investigators at New York University College of Dentistry and the Renal Research Institute, New York, United States, pointed out that haemodialysis patients face a 25 percent annual mortality rate. Half the reported deaths could be attributed to cardiovascular disease.
All-cause mortality and cardiovascular mortality correlated with such acute-phase proteins as C-reactive protein. Hepatic C-reactive protein synthesis was upregulated by inflammation but elevated C-reactive protein values were often found without any apparent infection or inflammation, the investigators said.
Because destructive periodontal diseases had been associated with elevated C-reactive protein values, they looked into whether destructive periodontal diseases could contribute to these in haemodialysis patients.
The investigators used an enzyme-linked immunosorbent assay to study sera from 86 consecutive dentate haemodialysis patients for levels of immunoglobulin G antibody to six periodontal species.
They found C-reactive protein of < 6.9-159 (median 8.2) mg/L. Comparisons between patients with or without elevated C-reactive protein levels (>10 mg/L) showed that rises in C-reactive protein levels were associated significantly with larger doses of human recombinant erythropoietin and lower levels of haemoglobin, serum iron, transferrin saturation, albumin averaged over the three preceding months, total cholesterol and triglycerides.
Log serum immunoglobulin G antibody levels to Porphyromonas gingivalis were also significantly greater in those with raised C-reactive protein levels.
Further statistical analysis showed that log serum antibody levels to Porphyromonas gingivalis remained significant after controlling for non-periodontal sources of elevated C-reactive protein, haemoglobin, transferrin saturation and triglycerides.
American Journal of Kidney Diseases 2002;40(5):983-989.
"Serum markers of periodontal disease status and inflammation in hemodialysis patients."
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