Relationship Between Chronic Periodontitis And Inflammatory Factors In Maintenance Hemodialysis Patients

Objectives: To compare the prevalence of dental caries and periodontitis in patients with end-stage renal disease(ESRD)treated with maintenance hemodialysis and healthy controls.Secondly,to evaluate inflammatory cytokine levels in gingival crevicular fluid(GCF)and serum between the two groups,and to investigate the correlation of inflammatory cytokine in GCF and serum,as well as the association with periodontal parameters.Methods: Maintenance hemodialysis patients who met the inclusion and exclusion criteria were selected as the maintenance hemodialysis(MHD)group,and healthy persons who underwent oral examination in the physical examination center were selected as the control group.Dental caries level was assessed by DMFT index and periodontal condition was assessed by visual plaque index,calculus index,gingival bleeding index,periodontal pocket depth and clinical attachment loss.GCF and serum samples were collected,and levels of eight inflammatory cytokines were measured using Luminex and ELISA assays.Results: A total of 63 maintenance hemodialysis patients and 75 healthy persons were included in this study.The prevalence of dental caries and mean DMFT scores in MHD group were significantly higher than that in the control group(90.5% vs 70.7%,4.6 vs 3.2,P<0.05).The prevalence of moderate/severe of periodontitis in MHD group were also significantly higher than that in control group(88.9% vs 66.7%,P<0.05).The levels of IL-6,IL-8 and CRP in GCF of MHD group were significantly higher than of the control group.The levels of IL-8,TNF-α,CRP,MCP-1 and MMP-8 in serum of MHD group were also significantly higher than those of control group.Levels of CRP in GCF were positively correlated with TNF-α,CRP,MCP-1 and MMP-8 in serum(P<0.05).Conclusion: Dental caries and periodontitis level of MHD patients were worse than those of heathy population.CRP is involved in the development of ESRD and periodontitis,and may play a role in the association between ESRD and periodontitis.Serum levels of MCP-1,TNF-α,MMP-8 may be involved in the progression of ESRD and periodontitis by affecting CRP levels in GCF.