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Periodontal and chronic kidney disease association: A systematic review and meta‐analysis
Author(s) -
Kapellas Kostas,
Singh Ankur,
Bertotti Maitê,
Nascimento Gustavo G.,
Jamieson Lisa M
Publication year - 2019
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.13225
Subject(s) - medicine , kidney disease , meta analysis , cochrane library , confounding , observational study , periodontitis , odds ratio , chronic periodontitis , medline , odds , logistic regression , law , political science
Aim Chronic kidney disease (CKD) and kidney failure is increasing globally and evidence from observational studies suggest periodontal disease may contribute to kidney functional decline. Methods Electronic searches of the PubMed, EMBASE, Web of Science, Scopus and Cochrane Library databases were conducted for the purposes of conducting a systematic review. Hand searching of reference lists was also performed. Meta‐analysis of observational studies involving periodontal disease and chronic kidney disease in adults was performed. Results A total of 17 studies was selected from an initial 4055 abstracts. Pooled estimates indicated the odds of having CKD were 60% higher among patients with periodontitis: pooled OR 1.60 (95% CI 1.44–1.79, I 2 35.2%, P = 0.11) compared to those without. Conversely, a similar magnitude but non‐significant higher odds of having periodontal disease was found among people with CKD 1.69 (95% CI: 0.84, 3.40, I 2 = 89.8%, P < 0.00) versus non‐CKD. Meta‐regression revealed study quality based on the Newcastle‐Ottawa Scale and statistical adjustment for potential confounders explained almost 35% of the heterogeneity in the studies investigating the association between CKD and periodontitis. Conclusions Moderate evidence for a positive association between periodontitis and CKD exists. Evidence for the opposite direction is extremely weak based on significant heterogeneity between studies.