Short-term assessment of non-surgical periodontal therapy reduces oral pathogens and pro-inflammatory cytokines, enhancing clinical outcomes in patients with chronic kidney disease.

BACKGROUND

Periodontal diseases have been reported to be associated with chronic kidney disease (CKD) progression. Thus, this study aimed to evaluate non-surgical periodontal therapy (NSPT) in patients with CKD disease progression by monitoring oral parameters, pathogen levels, cytokine profiles, and kidney function.

METHODS

Forty-five participants (age 60.0 ± 8.5 years) were examined at baseline and at 3 months after NSPT for oral parameters, oral pathogens (Porphyromonas gingivalis, Fusobacterium nucleatum, Aggregatibacter actinomycetemcomitans, Candida albicans), cytokines (IL-6, IL-8, TNF-α, IL-10), and kidney functions (serum creatinine, eGFR, urine protein-creatinine ratio).

RESULTS

At baseline, the CKD patients were diagnosed with stage II-IV periodontitis and exhibited measurable periodontal pathogen levels (P. gingivalis, 1.2 log CFU/mL; F. nucleatum, 4.4 log CFU/mL; A. actinomycetemcomitans, 0.3 log CFU/mL; and C. albicans, 4.1 log CFU/mL). Concurrently, pro-inflammatory cytokine concentrations were recorded at 0.2-4.4 pg/mL for IL-6, 1.9-25.5 pg/mL for IL-8, and 0.0-26.1 pg/mL for TNF-α. Conversely, IL-10 levels ranged from 0.0 to 13.2 pg/mL. After 3 months of NSPT, the levels of pathogens (1.1-10.9 fold) and cytokines (1.2-2.6 fold) were significantly reduced, while IL-10 levels significantly increased (0.7-1.9 fold). The number of patients showing improvement for serum creatinine and urine protein-creatinine ratio in CKD patients was 59.1-71.4% and 60.9-90.0%, respectively.

CONCLUSION

Our findings suggest that NSPT may benefit CKD patients by reducing oral pathogens and inflammation while increasing IL-10. There was evidence of a possible trend towards enhanced kidney function in CKD patients treated with NSPT.

TRIAL REGISTRATION: The study was registered in the Thai Clinical Trials Registry (TCTR20240516002; registered date 16 May 2024), Thailand.