Periodontal Disease and Incident CKD in US Hispanics/Latinos: The Hispanic Community Health Study/Study of LatinosPlain-Language Summary

• Main Authors: Stephanie M. Toth-Manikowski, MD, Ana C. Ricardo, MD, Christian R. Salazar, PhD, Jinsong Chen, PhD, Tasneem Khambaty, PhD, Jannel Liu, BS, Richard H. Singer, DMD, MS, PhD, Marston E. Youngblood, MPH, Jianwen Cai, PhD, Linda M. Kaste, DDS, PhD, Martha L. Daviglus, MD, James P. Lash, MD
• Format: Article
• Language: English
• Published: Elsevier 2021-07-01
• Series: Kidney Medicine
• Subjects: chronc kidney disease; periodontal disease
• Online Access: http://www.sciencedirect.com/science/article/pii/S259005952100145X
• ISSN: 2590-0595

Rationale &amp; Objective: Recent studies suggest that periodontal disease may be associated with incident chronic kidney disease (CKD). However, studies have focused on older populations, and US Hispanics/Latinos were not well represented. Study Design: Observational cohort. Setting &amp; Participants: We analyzed data from the Hispanic Community Health Study/Study of Latinos who completed a baseline visit with a periodontal examination and a follow-up visit, and did not have CKD at baseline. Predictors: Predictors included ≥30% of sites with clinical attachment loss ≥3 mm, ≥30% of sites with probing depth ≥4 mm, percentage of sites with bleeding on probing, and absence of functional dentition (<21 permanent teeth present). Outcomes: Outcomes were incident low estimated glomerular filtration rate (eGFR) (eGFR <60 mL/min/1.73 m2 and decline in eGFR ≥1 mL/min/year); incident albuminuria (urine albumin:creatinine ratio [ACR] ≥30 mg/g); and change in eGFR and ACR. Analytic Approach: Poisson and linear regression. Results: For the sample (n = 7.732), baseline mean age was 41.5 years, 45.2% were male, 11.7% had ≥30% of sites with clinical attachment loss ≥3 mm, 5.1% had ≥30% of sites with probing depth ≥4 mm, 30.7% had ≥50% of sites with bleeding on probing, and 16.2% had absent functional dentition. During a median follow-up of 5.9 years, 149 patients developed low eGFR and 415 patients developed albuminuria. On multivariable analysis, presence versus absence of ≥30% of sites with probing depth ≥4 mm and absence of functional dentition were each associated with increased risk for incident low eGFR (incident density ratio, 2.31; 95% CI, 1.14-4.65 and 1.65, 95% CI, 1.01-2.70, respectively). None of the other predictors were associated with outcomes. Limitations: Only a single kidney function follow-up measure. Conclusions: In this cohort of US Hispanics/Latinos, we found that select measures of periodontal disease were associated with incident low eGFR. Future work is needed to assess whether the treatment of periodontal disease may prevent CKD.