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中华口腔医学研究杂志(电子版) ›› 2019, Vol. 13 ›› Issue (02) : 119 -123. doi: 10.3877/cma.j.issn.1674-1366.2019.02.010

所属专题： 口腔医学； 文献；

综述

牙周炎和慢性肾脏病之间相互影响及作用机制的研究进展
吴红雨1, 叶玮1, 陆海霞1,†()   
  1. 1. 上海交通大学医学院附属第九人民医院·口腔医学院口腔预防科，国家口腔疾病临床医学研究中心，上海市口腔医学重点实验室，上海市口腔医学研究所　200011
  • 收稿日期:2018-12-12 出版日期:2019-04-01
  • 通信作者: 陆海霞

Research progress on the study of the interaction and mechanism between periodontitis and chronic kidney disease

Hongyu Wu1, Wei Ye1, Haixia Lu1,†()   

  1. 1. Department of Preventive Dentistry, Shanghai Ninth People′s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai 200011, China
  • Received:2018-12-12 Published:2019-04-01
  • Corresponding author: Haixia Lu
  • About author:
    Corresponding author: Lu Haixia, Email:
  • Supported by:
    Shanghai′s top priority clinical medicine center(2017ZZ01011); National Key R&D Program of China(2017YFC0840100, 2017YFC0840110)
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吴红雨, 叶玮, 陆海霞. 牙周炎和慢性肾脏病之间相互影响及作用机制的研究进展[J]. 中华口腔医学研究杂志(电子版), 2019, 13(02): 119-123.

Hongyu Wu, Wei Ye, Haixia Lu. Research progress on the study of the interaction and mechanism between periodontitis and chronic kidney disease[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2019, 13(02): 119-123.

牙周炎是发生在牙齿支持组织的慢性感染性疾病，是成人牙缺失的主要原因之一。慢性肾脏病被认为是21世纪人类面临的全球性公共健康问题，其危害仅次于肿瘤和心脏病。目前，大量研究发现牙周炎和慢性肾脏病间关系密切，可能存在一定相关性。中等证据表明，牙周炎对慢性肾脏病具有一定影响作用；轻度证据表明，慢性肾脏病对牙周炎存在影响作用，两者可能互为危险因素。对于合并牙周炎的慢性肾脏病患者，实施牙周干预治疗可以减轻其炎症负担，改善患者的炎症和营养状态，从而利于其预后。目前，关于牙周治疗对慢性肾脏病患者肾功能影响作用的相关研究较少，且尚未有明确结论。本文介绍了近几年关于牙周炎与慢性肾脏病之间相互影响及其发病机制的研究进展，并且讨论了目前研究中存在的问题以及未来需要解决的工作。

关键词: 牙周炎, 肾疾病，慢性, 危险因素, 发病机制

Periodontitis is a chronic inflammatory condition that occurs in the periodontal supporting tissue, which is one of the main reasons for the loss of teeth among adults. Chronic kidney disease (CKD) is considered as a global public health problem in the 21st century, and ranked the third top healthy killer only after cancer and heart attack. At present, a large number of studies have found that periodontitis and chronic kidney disease are closely related. Moderate evidence indicates that periodontitis has a certain impact on chronic kidney disease. Evidence for the opposite direction is extremely weak, while the two diseases may be risk factors for each other. For patients with chronic kidney disease complicated with periodontitis, the implementation of periodontal intervention treatment can help reduce the burden of inflammation and improve nutritional status of patients, which can contribute to good prognosis. Until now, few studies focus on the effect of periodontal therapy on renal function in patients with chronic kidney disease, and no definite conclusions have been drawn.This review introduces the progress of the research on the interaction between periodontitis and chronic kidney disease as well as its pathogenesis in recent years. We also discuss the existing problems and the future work on it.

Key words: Periodontitis, Kidney disease, chronic, Risk factors, Pathogenesis
[1]
Zhang L, Wang F, Wang L，et al. Prevalence of chronic kidney disease in China：a cross-sectional survey[J]. Lancet，2012，379(9818):815-822. DOI：10.1016/S0140-6736(12)60033-6.
[2]
Pihlstrom BL, Michalowicz BS, Johnson NW. Periodontal diseases [J]. Lancet，2005，366(9499):1809-1820. DOI：10.1016/S0140-6736(05)67728-8.
[3]
Dietrich T, Sharma P, Walter C，et al. The epidemiological evidence behind the association between periodontitis and incident atherosclerotic cardiovascular disease[J]. J Periodontol，2013，84(4 Suppl):S70-S84. DOI：10.1902/jop.2013.134008.
[4]
Schomig M, Eisenhardt A, Ritz E. The microinflammatory state of uremia[J]. Blood Purif，2000，18(4):327-332. DOI：10.1159/000014457.
[5]
Akram Z, Abduljabbar T, Abu Hassan MI，et al. Cytokine Profile in Chronic Periodontitis Patients with and without Obesity：A Systematic Review and Meta-Analysis[J]. Dis Markers，2016(20162):4801418. DOI：10.1155/2016/4801418.
[6]
Kshirsagar AV, Moss KL, Elter JR，et al. Periodontal disease is associated with renal insufficiency in the Atherosclerosis Risk In Communities（ARIC）study[J]. Am J Kidney Dis，2005，45(4):650-657. DOI：10.1053/j.ajkd.2004.12.009.
[7]
Kshirsagar AV, Craig RG, Beck JD，et al. Severe periodontitis is associated with low serum albumin among patients on maintenance hemodialysis therapy[J]. Clin J Am Soc Nephrol，2007，2(2):239-244. DOI：10.2215/CJN.02420706.
[8]
Fisher MA, Taylor GW, West BT，et al. Bidirectional relationship between chronic kidney and periodontal disease：a study using structural equation modeling[J]. Kidney Int，2011，79(3):347-355. DOI：10.1038/ki.2010.384.
[9]
Han SS, Shin N, Lee SM，et al. Correlation between periodontitis and chronic kidney disease in Korean adults[J]. Kidney Res Clin Pract，2013，32(4):164-170. DOI：10.1016/j.krcp.2013.09.001.
[10]
Liu K, Liu Q, Chen W，et al. Prevalence and risk factors of CKD in Chinese patients with periodontal disease[J]. PLoS One，2013，8(8):e70767. DOI：10.1371/journal.pone.0070767.
[11]
Iwasaki M, Taylor GW, Nesse W，et al. Periodontal disease and decreased kidney function in Japanese elderly[J]. Am J Kidney Dis，2012，59(2):202-209. DOI：10.1053/j.ajkd.2011.08.027.
[12]
Chen YT, Shih CJ, Ou SM，et al. Periodontal Disease and Risks of Kidney Function Decline and Mortality in Older People：A Community-Based Cohort Study[J]. Am J Kidney Dis，2015，66(2):223-230. DOI：10.1053/j.ajkd.2015.01.010.
[13]
Grubbs V, Vittinghoff E, Beck JD，et al. Association Between Periodontal Disease and Kidney Function Decline in African Americans：The Jackson Heart Study[J]. J Periodontol，2015，86(10):1126-1132. DOI：10.1902/jop.2015.150195.
[14]
Almeida S, Figueredo CM, Lemos C，et al. Periodontal treatment in patients with chronic kidney disease：a pilot study[J]. J Periodontal Res，2017，52(2):262-267. DOI：10.1111/jre.12390.
[15]
Artese HP, Sousa CO, Luiz RR，et al. Effect of non-surgical periodontal treatment on chronic kidney disease patients[J]. Braz Oral Res，2010，24(4):449-454. DOI：10.1590/S1806-83242010000400013.
[16]
Fang F, Wu B, Qu Q，et al. The clinical response and systemic effects of non-surgical periodontal therapy in end-stage renal disease patients：a 6-month randomized controlled clinical trial [J]. J Clin Periodontol，2015，42(6):537-546. DOI：10.1111/jcpe.12411.
[17]
Tonetti MS, D′Aiuto F, Nibali L，et al. Treatment of periodontitis and endothelial function[J]. N Engl J Med，2007，356(9):911-920. DOI：10.1056/NEJMoa063186.
[18]
Langsford D, Tang M, Cheikh Hassan HI，et al. The Association between Biomarker Profiles，Etiology of Chronic Kidney Disease，and Mortality[J]. Am J Nephrol，2017，45(3):226-234. DOI：10.1159/000454991.
[19]
Graziani F, Cei S, La Ferla F，et al. Effects of non-surgical periodontal therapy on the glomerular filtration rate of the kidney：an exploratory trial[J]. J Clin Periodontol，2010，37(7):638-643. DOI：10.1111/j.1600-051X.2010.01578.x.
[20]
Scannapieco FA. Systemic effects of periodontal diseases[J]. Dent Clin North Am，2005，49(3):533-550,vi.
[21]
Kshirsagar AV, Offenbacher S, Moss KL，et al. Antibodies to periodontal organisms are associated with decreased kidney function. The Dental Atherosclerosis Risk In Communities study[J]. Blood Purif，2007，25(1):125-132.
[22]
Shankar A, Sun L, Klein BE，et al. Markers of inflammation predict the long-term risk of developing chronic kidney disease：a population-based cohort study[J]. Kidney Int，2011，80(11):1231-1238. DOI：10.1038/ki.2011.283.
[23]
Amdur RL, Feldman HI, Gupta J，et al. Inflammation and Progression of CKD：The CRIC Study[J]. Clin J Am Soc Nephrol，2016，11(9):1546-1556. DOI：10.2215/CJN.13121215.
[24]
Remuzzi G, Ruggenenti P, Perico N. Chronic renal diseases：renoprotective benefits of renin-angiotensin system inhibition [J]. Ann Intern Med，2002，136(8):604-615. DOI：10.7326/0003-4819-136-8-200204160-00010.
[25]
Brotto RS, Vendramini RC, Brunetti IL，et al. Lack of Correlation between Periodontitis and Renal Dysfunction in Systemically Healthy Patients[J]. Eur J Dent，2011，5(1):8-18.
[26]
Grubbs V, Plantinga LC, Crews DC，et al. Vulnerable populations and the association between periodontal and chronic kidney disease[J]. Clin J Am Soc Nephrol，2011，6(4):711-717. DOI：10.2215/CJN.08270910.
[27]
Akar H, Akar GC, Carrero JJ，et al. Systemic consequences of poor oral health in chronic kidney disease patients[J]. Clin J Am Soc Nephrol，2011，6(1):218-226. DOI：10.2215/CJN.05470610.
[28]
Pradeep AR, Kathariya R, Arjun Raju P，et al. Risk factors for chronic kidney diseases may include periodontal diseases，as estimated by the correlations of plasma pentraxin-3 levels：a case-control study[J]. Int Urol Nephrol，2012，44(3):829-839. DOI：10.1007/s11255-011-9997-7.
[29]
Anding K, Gross P, Rost JM，et al. The influence of uraemia and haemodialysis on neutrophil phagocytosis and antimicrobial killing[J]. Nephrol Dial Transplant，2003，18(10):2067-2073. DOI：10.1093/ndt/gfg330.
[30]
Chambrone L, Foz AM, Guglielmetti MR，et al. Periodontitis and chronic kidney disease：a systematic review of the association of diseases and the effect of periodontal treatment on estimated glomerular filtration rate[J]. J Clin Periodontol，2013，40(5):443-456. DOI：10.1111/jcpe.12067.
[31]
Davidovich E, Schwarz Z, Davidovitch M，et al. Oral findings and periodontal status in children，adolescents and young adults suffering from renal failure[J]. J Clin Periodontol，2005，32(10):1076-1082. DOI：10.1111/j.1600-051X.2005.00812.x.
[32]
Ertuğrul F, Elbek-Cubukçu C, Sabah E，et al. The oral health status of children undergoing hemodialysis treatment[J]. Turk J Pediatr，2003，45(2):108-113.
[33]
Ioannidou E, Swede H. Disparities in periodontitis prevalence among chronic kidney disease patients[J]. J Dent Res，2011，90(6):730-734. DOI：10.1177/0022034511402209.
[34]
Ruospo M, Palmer SC, Craig JC，et al. Prevalence and severity of oral disease in adults with chronic kidney disease：a systematic review of observational studies[J]. Nephrol Dial Transplant，2014，29(2):364-375. DOI：10.1093/ndt/gft401.
[35]
Ausavarungnirun R, Wisetsin S, Rongkiettechakorn N，et al. Association of dental and periodontal disease with chronic kidney disease in patients of a single，tertiary care centre in Thailand [J]. BMJ Open，2016，6(7):e011836. DOI：10.1136/bmjopen-2016-011836.
[36]
Tadakamadla J, Kumar S, Mamatha GP. Comparative evaluation of oral health status of chronic kidney disease（CKD）patients in various stages and healthy controls[J]. Spec Care Dentist，2014，34(3):122-126. DOI：10.1111/scd.12040.
[37]
Garcez J, Limeres Posse J, Carmona IT，et al. Oral health status of patients with a mild decrease in glomerular filtration rate[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod，2009，107(2):224-228. DOI：10.1016/j.tripleo.2008.09.018.
[38]
Sharma P, Dietrich T, Sidhu A，et al. The periodontal health component of the Renal Impairment In Secondary Care（RIISC）cohort study：a description of the rationale，methodology and initial baseline results[J]. J Clin Periodontol，2014，41(7):653-661. DOI：10.1111/jcpe.12263.
[39]
Cohen G, Haag-Weber M, Horl WH. Immune dysfunction in uremia[J]. Kidney Int Suppl，1997(62):S79-S82.
[40]
Kato S, Chmielewski M, Honda H，et al. Aspects of immune dysfunction in end-stage renal disease[J]. Clin J Am Soc Nephrol，2008，3(5):1526-1533. DOI：10.2215/CJN.00950208.
[41]
Takeuchi Y, Ishikawa H, Inada M，et al. Study of the oral microbial flora in patients with renal disease[J]. Nephrology （Carlton），2007，12(2):182-190. DOI：10.1111/j.1440-1797.2007.00767.x.
[42]
Bastos JA, Diniz CG, Bastos MG，et al. Identification of periodontal pathogens and severity of periodontitis in patients with and without chronic kidney disease[J]. Arch Oral Biol，2011，56(8):804-811. DOI：10.1016/j.archoralbio.2010.12.006.
[43]
Salam SN, Eastell R, Khwaja A. Fragility fractures and osteoporosis in CKD：pathophysiology and diagnostic methods [J]. Am J Kidney Dis，2014，63(6):1049-1059. DOI：10.1053/j.ajkd.2013.12.016.
[44]
Klassen JT, Krasko BM. The dental health status of dialysis patients[J]. J Can Dent Assoc，2002，68(1):34-38.
[45]
Proctor R, Kumar N, Stein A，et al. Oral and dental aspects of chronic renal failure[J]. J Dent Res，2005，84(3):199-208.
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