The Effect of Periodontal Treatment on Systemic Inflammatory Status in Hemodialysis Patients with Periodontitis: A Randomized Controlled Study

Chronic kidney disease (CKD) is a worldwide health problem. Patients are characterized by a uremic milieu, which has been associated with immunosuppression. Although disturbances of the immune system in CKD contribute to the increased rate of infections such as periodontitis, the response to periodontal therapy has never been evaluated in hemodialysis patients. Hence, the objective of this study was to assess the clinical response to non-surgical periodontal treatment in hemodialysis patients with periodontitis.10 CKD subjects on hemodialysis were recruited from multiple dialysis centers. All subjects received a full-mouth periodontal examination and a blood draw to assess the inflammatory markers. Patients were randomly assigned in two groups by a computer generated randomization list. The provider assessing the final outcomes was blinded to the subject allocation. The test group received oral hygiene instructions and scaling and root planing, whereas the control group received oral hygiene instructions and full mouth supragingival debridement. The subjects were recalled at 2 months for reevaluation.When the baseline parameters were compared between the two groups, no difference was found. At the end of the treatment in the between group comparison, we found that only the improvement in clinical attachment level was statistically significant (p=0.050). Pocket depth, plaque score, bleeding on probing, CRP and IL-6 values had decreased after intervention but the values were not statistically significant.Our results highlighted that CKD subjects on hemodialysis with periodontitis positively respond to periodontal therapy. A positive correlation was also seen when periodontal parameters were correlated with the inflammatory markers.