Impact of untreated periodontal disease, periodontal treatment, and regular dental prophylaxis on chronic kidney disease outcomes

Rationale & ObjectivePeriodontal disease(PD), a chronic inflammatory condition, may contribute to chronic kidney disease(CKD) through systemic inflammation, but its impact on CKD outcomes and the potential protective effects of periodontal treatment and routine dental prophylaxis remain uncertain. This study evaluated associations between PD, dental interventions, and kidney outcomes in a large U.S. veteran cohort. Study DesignRetrospective cohort study. Setting & ParticipantsUsing Veterans Health Administration data(2009-2019), we identified 86,376 adults eligible for comprehensive dental care with baseline eGFR >60 mL/min/1.73m{superscript 2} and followed them from their initial dental examination. ExposurePatients with PD (Cohort-A) were divided into those who received periodontal treatment (PD-Treated), those who did not receive treatment but had [&ge;]1 dental prophylaxis visit/year (PD-Prophylaxis), and those who received neither (PD-Untreated). Those without PD (Cohort-B) were grouped by presence or absence of regular dental prophylaxis ([&ge;]1 visit/year). OutcomeIncident CKD (eGFR <60 mL/min/1.73 m{superscript 2} and >25% decline from baseline), [&ge;]40% eGFR reduction, and incident albuminuria (>30 mg/g), each confirmed with repeat labs [&ge;]90 days apart. Analytical ApproachMultivariable logistic regression model ResultsOf 86,376 veterans (mean age 57.17{+/-}12.59 years; 91.4% male), 37.6% had PD. Adjusted model showed significantly lower odds of incident CKD, [&ge;]40% eGFR decline, and incident albuminuria noted in both PD-Treated [OR(95%CI): 0.80(0.70-0.91), 0.69(0.56-0.84), 0.88 (0.79-0.99)] and PD-Prophylaxis groups [OR(95%CI): 0.81(0.66-0.98), 0.60(0.43-0.82), 0.79(0.67-0.94)] compared to the PD-Untreated. Similarly, among patients without PD, regular dental prophylaxis was associated with reduced odds of Incident CKD, [&ge;]40% eGFR decline, and incident albuminuria [OR(95%CI): 0.87(0.78-0.96), 0.76(0.65-0.90), 0.85(0.78-0.93)]. LimitationsRetrospective design, unmeasured confounders, and reliance on electronic health records. ConclusionsPD is associated with increased risks of incident CKD, accelerated eGFR decline, and new-onset albuminuria. Periodontal treatment and routine dental prophylaxis mitigate these risks. Even in individuals without PD, regular dental prophylaxis appears protective against CKD development and progression.