The Effect of Periodontal Therapy on Renal Function and Diabetes Control in Patients with Chronic Kidney Disease. A Randomised Controlled Clinical Trial
(Journal of Clinical Periodontology; doi: 10.1111/jcpe.70059)
Spyridon K Kouris, Yiorgos A Bobetsis, Sophia Lionaki, Panagiotis N Kanellopoulos, George Maropoulos, Panagiotis A Koromantzos, Athanasios D Protogerou, Phoebus N Madianos
People with chronic kidney disease may also have periodontitis.
Researchers wanted to find out whether treating gum inflammation could improve measurements of kidney health and, in people with diabetes, blood glucose.
A Greek clinical trial randomly allocated sixty people with kidney disease and periodontitis to gum treatment or comparison care.
Fifty-three were included in the reported analysis, including thirty-two with diabetes.
Follow-up lasted six months.
The treatment group had healthier gums, lower inflammation markers and better estimated kidney filtration than the comparison group. Among participants with diabetes, HbA1c was about half a percentage point lower after adjustment for starting differences. However, the difference in urine protein leakage was not clear after allowing for the number of statistical comparisons. No long-term kidney failure outcome was established.
These results are promising, but the trial was too small and short to show that gum treatment prevents dialysis or slows kidney disease over many years.
Changes in medicines and complex medical conditions also matter.
The study supports further research on coordinated dental and medical care. It does not justify changing kidney or diabetes treatment in response to a dental improvement alone.
Only 53 of the 60 people randomly allocated contributed to the reported analysis.
The most useful comparison is the difference between the treatment groups, rather than improvement within just one group.
Results also depend on who took part, the comparison care and how long people were followed. A statistically uncertain difference does not prove two approaches are identical. Equally, a clear difference in a measurement may not show a lasting benefit for tooth retention or general health.
These findings need to be considered alongside other trials and your individual clinical needs when discussing treatment choices.
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Periodontitis is the 6th most prevalent condition globally
Periodontitis and diabetes are bidirectionally linked
Diabetic complications are increased if you have both diseases
Successful periodontal treatment can improve blood glucose control
Periodontitis is the 6th most prevalent condition globally
Periodontitis and diabetes are bidirectionally linked
Diabetic complications are increased if you have both diseases
Successful periodontal treatment can improve blood glucose control
