A causative link between periodontal disease and glomerulonephritis: a preliminary study

Abstract

Mohammad Reza Ardalan1, Kamyar Ghabili2, Reza Pourabbas3, Mohammadali M Shoja41Department of Nephrology, Dialysis, and Transplantation, 2Tuberculosis and Lung Disease Research Center, 3Dental and Periodontal Research Center; 4Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, IranBackground: Periodontal disease has been associated with a number of systemic diseases. A high prevalence of periodontitis among individuals with chronic kidney diseases and end-stage renal disease has been reported. However, no association between periodontal diseases and glomerulonephritis has previously been investigated.Objective: The aim of this study was to assess the severity and possible role of periodontitis in a group of patients with unknown primary glomerulonephritis.Methods: Ten patients with unknown primary glomerulonephritis, and who had a renal biopsy with stable renal function and serum creatinine <1.6 mg/dL, were recruited. Severity of the periodontal disease was clinically measured with plaque index (PI), gingival index (GI), and periodontal pocket depth (PD). The subjects received appropriate dental treatments where indicated. The patients were also put on angiotensin-converting enzyme inhibitor or angiotensin receptor blockers for controlling blood pressure and proteinuria. Six months following appropriate periodontal treatment, renal function, degree of proteinuria, and level of C-reactive protein (CRP) were measured in each individual.Results: The median age of the patients was 30 (15.8) years. The median urine protein excretion was lower following the periodontal therapy (P = 0.008). Prior to the dental and/or periodontal therapies, the median PI, PD, and GI were 57.5%, 4.3, and 1.1, respectively. The majority of the patients had advanced periodontal disease. In four patients, +2/+3 CRP turned negative after periodontal treatment.Conclusions: The present study revealed that a causative link might exist between periodontal disease and glomerulonephritis.Keywords: glomerulonephritis, periodontal disease, gingivitis, proteinuria