The relationship between periodontal status and hyperglycemia after kidney transplantation.

OBJECTIVES: Several factors have been associated with hyperglycemia after kidney transplantation (KTx), including systemic inflammation. This study aimed to investigate the relationship between periodontal status and hyperglycemia in KTx patients. MATERIALS AND METHODS: Forty-four KTx patients were included in this cross-sectional study. Periodontitis severity was categorized into stage I to IV. Fasting blood glucose (FBG) was measured, and hyperglycemia was analyzed at different FBG cutoff points (100 mg/dL, 110 mg/dL, 120 mg/dL, 126 mg/dL, 140 mg/dL). Age, history of smoking, prior type 2 diabetes (T2D), and prior cardiovascular disease (CVD) were considered cofounders. Multivariable logistic regression modelling was performed with periodontitis as the exposure and hyperglycemia as the outcome. Pathway analysis was performed with FBG as a continuous outcome. RESULTS: Periodontitis had increased odds of hyperglycemia from 120 mg/dL FBG cutoff, even after adjustment. In addition, periodontitis severity was positively associated with FBG level (ß = 0.323, SE = 0.127, P = 0.011). CONCLUSION: The findings suggest that periodontitis may be related to increase of hyperglycemia and FBG levels in KTx patients. CLINICAL RELEVANCE: Periodontitis severity and cardiovascular disease were positively associated with FBG levels in KTx patients. Clinicians and patients should be aware of the potential benefit of periodontal care for better glycemic control management.

Periodontal status and clinical outcomes in kidney transplant recipients: A systematic review.

OBJECTIVE: The aim of this systematic review was to identify clinical outcomes following kidney transplantation associated with periodontal status. MATERIAL AND METHODS: A systematic review was conducted and included cross-sectional, case-control, or cohort studies published until August 2018 from PubMed/MEDLINE, Scopus, Science Direct, and CENTRAL. The research was carried out using the following descriptors: "kidney transplantation," "chronic renal failure," "periodontal diseases," "periodontitis," "chronic periodontitis," "gingival hyperplasia," and "gingivitis." The outcomes comprised the clinical transplantation variables. Two independent reviewers extracted the data and assessed the quality of the studies using Newcastle-Ottawa scale. RESULTS: The electronic search revealed 1,063 potentially relevant studies. We selected 114 articles for reading the full text. Therefore, six studies met the inclusion criteria: one case-control, three cross-sectional, and two cohort studies. All studies showed low risk of bias. The findings suggest that the periodontal status may be associated with the largest left ventricular mass, greater carotid thickness, graft rejection, lower graft survival, and a higher mortality rate within 60 months among kidney transplant recipients. CONCLUSION: The findings of this systematic review indicate that there is an association between periodontal status and worsening of graft function and systemic health among kidney transplant recipients.