Vulnerable Populations and the Association between Periodontal and Chronic Kidney Disease

被引:57
作者
Grubbs, Vanessa [1 ]
Plantinga, Laura C. [2 ]
Crews, Deidra C. [3 ]
Bibbins-Domingo, Kirsten [2 ]
Saran, Rajiv [4 ]
Heung, Michael [4 ]
Patel, Priti R. [5 ]
Burrows, Nilka Rios [6 ]
Ernst, Kristina L. [6 ]
Powe, Neil R. [2 ]
机构
[1] Univ Calif San Francisco, San Francisco Gen Hosp, Renal Ctr, Div Nephrol, San Francisco, CA 94110 USA
[2] Univ Calif San Francisco, San Francisco Gen Hosp, Dept Med, San Francisco, CA 94110 USA
[3] Johns Hopkins Univ, Dept Med, Div Nephrol, Baltimore, MD USA
[4] Univ Michigan, Dept Internal Med, Div Nephrol, Ann Arbor, MI 48109 USA
[5] Ctr Dis Control & Prevent, Div Healthcare Qual Promot, Atlanta, GA USA
[6] Ctr Dis Control & Prevent, Div Diabet Translat, Atlanta, GA USA
来源
CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY | 2011年 / 6卷 / 04期
关键词
STAGE RENAL-DISEASE; POTENTIAL EXPLANATORY FACTORS; GLOMERULAR-FILTRATION-RATE; FOAM CELL-FORMATION; UNITED-STATES; PORPHYROMONAS-GINGIVALIS; ATHEROSCLEROSIS RISK; RACIAL-DIFFERENCES; SERUM CREATININE; AFRICAN-AMERICAN;
D O I
10.2215/CJN.08270910
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background and objectives Recent studies suggest an overall association between chronic kidney disease (CKD) and periodontal disease, but it is unknown whether this association is similar across various sub-populations. Design, setting, participants, & measurements This study was a cross-sectional analysis of 2001 to 2004 National Health and Nutrition Examination Survey data. CKD was defined as a urinary albumin-to-creatinine ratio >= 30 mg/g or estimated GFR of 15 to 59 ml/min per 1.73 m(2). Adjusted odds ratios were calculated using multivariable logistic regression with U.S. population-based weighting. Results These analyses included 6199 dentate adult participants (aged 21 to 75 years) with periodontal exams. The estimated prevalences of moderate/severe periodontal disease and CKD were 5.3% and 10.6%, respectively. Periodontal disease was associated with > 2-fold higher risk of CKD that was moderately attenuated after adjustment for age, gender, race/ethnicity, tobacco use, hypertension, diabetes, educational attainment, poverty index ratio, and dental care use. There were no statistically significant interactions between periodontal disease and race/ethnicity, educational attainment, or poverty status. Less-than-recommended dental care use was associated with periodontal disease and CKD and was increasingly prevalent among nonwhites, lower educational attainment, and lower poverty status. Conclusions The association between periodontal disease and CKD is not significantly different among subgroups. However, because nonwhites, those with a lower educational level, and the poor less frequently report use of recommended dental care, the association between periodontal disease and kidney function over time may become stronger among these groups and warrants further investigation. Clin J Am Soc Nephrol 6: 711-717, 2011. doi: 10.2215/CJN.08270910
引用
收藏
页码:711 / 717
页数:7
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