DT News - UK - Periodontitis linked to heart attacks in kidney disease patients

Dental Tribune International

Tue. 28 April 2015

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BIRMINGHAM, UK: Over 10 per cent of the adult population suffers from chronic kidney disease (CKD) and those affected often have poor health outcomes owing to an increased incidence of cardiovascular disease compared with the general population. A team of researchers at Aston University recently found that treating a common gingival condition in CKD patients could significantly reduce their risk of potentially fatal heart disease.

CKD progressively worsens kidney function, raises blood pressure, and can cause progressive vascular injury and heart disease. The latest research at the university suggests that increased mortality in people with CKD may be linked with chronic inflammatory conditions such as periodontitis, which causes gingival inflammation, loss of the bone that supports the teeth and ultimately tooth loss.

Previous studies have found that more than 85 per cent of people with CKD have inflammatory gingival problems, caused by inadequate removal of dental plaque from between the tooth and gingival margin and made worse by impaired immunity and wound healing. Experts have identified that bacteria in the mouth can enter the bloodstream through periodontal conditions, causing blood cells to malfunction and leading to clots and narrowing of the arteries.

Dr Irundika Dias of Aston’s School of Life and Health Sciences is currently leading a study into the underlying causes of increased cardiovascular disease and outcomes of accelerated progression observed in people with CKD and periodontitis. She will observe how successfully treating periodontitis reduces oxidised lipids and inflammatory cell activity in people with CKD, thereby lowering their risk of life-threatening heart disease.

“This project has the potential to make a real difference for people with CKD. If we can prove managing periodontitis reduces the threat of cardiovascular disease then it may well represent an efficient and cost effective treatment for CKD,” Dias stated. “In conjunction with our study, I will be talking to dental schools about alternative ways of helping periodontitis patients. It is vitally important to keep your gums healthy and have regular dental check-ups to avoid the onset of a disease that is very common, poorly appreciated by the public and causes tooth loss resulting in reduced quality of life.”

The study will involve 80 people, including healthy volunteers and 60 people with CKD, both with and without periodontitis. Among these will be a group of 20 people with CKD and periodontitis who will be randomised to have the gingival condition clinically treated over a 12-month period. They will be reviewed at three-monthly intervals to assess markers of cardiovascular disease, such as oxidative stress biomarkers in the blood and arterial stiffness.

The project is part of a collaboration between Dias and Prof. Helen Griffiths of Aston’s School of Life and Health Sciences, Prof. Iain Chapple, Head of Periodontology at the University of Birmingham, and Prof. Paul Cockwell, consultant nephrologist at University Hospitals Birmingham NHS Foundation Trust.

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