The relationship between
periodontitis and two measures of systemic
inflammation,
serum albumin and
C-reactive protein (CRP), were examined among patients who were receiving chronic outpatient
hemodialysis. Adult patients at two locations, North Carolina and New York City, were evaluated by dentist examiners. Six sites per tooth (up to 32 teeth per patient) were examined. A
periodontitis case was defined as > or = 60% of sites with attachment level > or = 4 mm. Multivariable logistic regression was used to determine the association of
periodontitis with low
serum albumin, defined as < 3.5 mg/dl, and with high CRP, defined as > 3.0 mg/dl. A total of 154 patients completed the study. The mean age was 54.6 yr (SD 13.3), and average duration of dialysis was 4.0 yr (3 mo to 16 yr). Eighty-six (54.6%) were men, and 89 (58.2%) were black. Common causes of
end-stage kidney disease were
hypertension (12.3%), diabetes (22.1%),
glomerulonephritis (7.1%), and other (58.4%). The average number of teeth was 20.3 (SD 8.4). Thirty-five (23%) patients were
periodontitis cases. Severe
periodontitis was associated with low
serum albumin (odds ratio 8.20; 95% confidence interval 1.61 to 41.82; P = 0.01) compared with individuals without severe
periodontitis disease after adjustment for age, gender, race, diabetes,
hypertension, body mass index, smoking, study site, total
cholesterol, serum
calcium, serum
phosphorus, and normalized
protein catabolic rate. There was no observed association of severe
periodontitis with CRP. Investigation of the potential contribution of
periodontitis to
serum albumin and possibly to morbidity and mortality among patients with
end-stage kidney disease seems warranted.