The effect of periodontitis on recipient outcomes after kidney transplantation
- 민현진; 박정수; Yang Jaeseok; Yang Jihyun; Oh Se Won; 조상경; 조원용; 권준교; 정철웅; 설양조; 박신영; 김명규
- Issue Date
- Cardiovascular diseases; Graft rejection; Kidney transplantation; Periodontitis
- Kidney Research and Clinical Practice, v.41, no.1, pp.114 - 123
- Journal Title
- Kidney Research and Clinical Practice
- Start Page
- End Page
- Background: Recent several reports have demonstrated that periodontitis is prevalent and adversely affects the survival in patients with chronic kidney disease (CKD) or end-stage kidney disease. However, its impact on transplant outcomes remains uncertain.
Methods: This retrospective cohort study included 136 and 167 patients, respectively, who underwent living donor kidney transplantation (KT) at Seoul National University Hospital from July 2012 to August 2016 and Korea University Hospital from April 2008 to October 2018. We divided patients into three groups according to stages of periodontitis based on a new classification system.
Results: Patients with severe periodontitis were older, had a higher prevalence of diabetes, a higher body mass index and C-reactive protein level, a lower cardiac output, and were more likely to be smokers, indicating its association with chronic systemic inflammation. After KT, stage IV periodontitis was independently associated with a lower incidence of acute T cell-mediated rejection, suggesting the possible effect of periodontitis on immune function. However, 1-year and 3-year estimated glomerular filtration rates were not different. Among the KT recipients followed up more than 3 years, new-onset cardiovascular disease occurred in nine patients, and coronary artery disease occurred more frequently in patients with stage IV periodontitis. However, diabetes was the independent predictor of new-onset coronary artery disease in multivariate logistic regression analysis.
Conclusion: Our findings showed that periodontitis might be an important player in determining posttransplant outcomes in recipients. Further interventional trials to test whether treating periodontitis could modify transplant outcome are needed.
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- 2. Clinical Science > Department of Transplantation and Vascular Surgery > 1. Journal Articles
- 2. Clinical Science > Department of Periodontology > 1. Journal Articles
- 2. Clinical Science > Department of Nephrology and Hypertension > 1. Journal Articles
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