Association of periodontal disease with the prognosis of chronic kidney disease - A meta-analysis

Sep 29, 2026

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Systematic review and meta-analysis assess the relationship between periodontal disease (PD) and prognosis in chronic kidney disease (CKD). Searches of PubMed, Embase, and Cochrane Library identified eligible cohort studies up to April 2023. Relative risk (RR) with 95% confidence intervals estimated associations using a random-effects model. Results from 10 cohort studies (10,144 CKD patients) showed PD linked to higher all-cause mortality, while cardiac death showed no initial association but was suggested by sensitivity and varied by region, sex, and CKD stage.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages8

Reading Time20 min

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Introduction

Methods

Literature search and selection criteria

Results

Conclusion

J Chin MedAssoc Original article Association of periodontal disease with the prognosis of chronic kidney disease: A meta-analysis Tao Hea, Xue Lia, Chun-Juan Liaoa, Xing-Yu Fenga, Xiang-Yu Guoa,* aThe State Key Laboratory of Oral Diseases, West China Hospital ofStomatology, Sichuan University, Chengdu, China Abstract Background: To assess the association between periodontal disease (PD) and the prognosis of chronic kidney disease (CKD) . Methods: A systematic literature search was conducted using PubMed, Embase, and Cochrane Library to identify eligible cohort studies until April 2023. Relative risk (RR) with a 95% CI was used to evaluate the strength of the relationship between PD and CKD prognosis using the random-effects model. Results: Ten cohort studies involving 10 144 patients with CKD were selected for the meta-analysis. The summary results indicated that PD was associated with an increased risk of all-cause mortality in patients with CKD (RR: 1.32; 95% CI, 1.10-1.59; p = 0.003) . Although no association was observed between PD and the risk of cardiac death in patients with CKD (p = 0. 180), while sensitivity analysis revealed PD may be associated with the risk of cardiac death (RR: 1.31; 95% CI, 1.05-1.64; p = 0 .017) . In addition, subgroup analyses revealed that the strength of the association of PD with the risks of all-cause mortality and cardiac death varies when stratified by region, sex, and CKD stage. Conclusion: PD might exert a harmful effect on the risk of all-cause mortality, with a potential but unconfirmed association with cardiac death in patients with CKD. Keywords: Cardiac death; Chronic kidney disease; Meta-analysis; Periodontal disease 1. INTRODUCTION Chronic kidney disease (CKD) is characterized by structural or functional abnormalities of the kidney persisting for >3 months; it affects ~700 million individuals and causes 1.2 million deaths annually worldwide.1 Nearly a third of patients with CKDare from China and India, and more than 2.5 million patients undergo kidney replacement therapy annually worldwide; however, this number is expected to double by 2030.1 Studies have reported that a rapid decline in renal function is significantly associated with increased risks of mortality and cardiovascular morbidity, irrespective of the baseline renal function.2,3 Patients with early-stage CKD present no symptoms, and >90% of these patients are unaware of the damage to their kidneys. Furthermore, effective treatments to stop or slow down the progression of CKD are limited.4 Thus, it is important to identify the prognostic factors of CKD and apply early intervention to modifiable factors to improve CKD prognosis. Periodontal disease (PD) is a chronic inflammatory and destructive disease of the gingiva, periodontal ligament, and *Address correspondence. Dr. Xiang-Yu Guo, The State Key Laboratory of Oral Diseases, West China Hospital ofStomatology, Sichuan University, 14, Renmin South Road, Chengdu, [China. E-mail address: jiacheng1027@163.com](China. E-mail address: jiacheng1027@163.com) (X.-Y. Guo). Conflicts of interest: The authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article. Journal of Chinese Medical Association. (2025) 88: 170-177. Received October 23, 2023; accepted July 12, 2024. doi: 10. 1097/JCMA.0000000000001178 Copyright © 2024, the Chinese Medical Association. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/](http://creativecommons.org/licenses/)[ ](http://creativecommons.org/licenses/)[by-nc-nd/4.0/](by-nc-nd/4.0/)) alveolar bone, mainly caused by gram-negative bacteria residing in dental plaque biofilms.5 In addition, it is considered a risk factor for several noncommunicable diseases, including diabetes mellitus (DM), cardiovascular diseases, and pulmonary diseases.5 Several studies have demonstrated the association between PD and th

FAQs

What was the purpose of this meta-analysis?

To evaluate the association between periodontal disease and the prognosis of chronic kidney disease using cohort studies.

Which studies and databases were included in the search?

Eligible cohort studies were identified by searching PubMed, Embase, and the Cochrane Library up to April 2023.

How did periodontal disease relate to CKD prognosis in the results?

PD was associated with increased all-cause mortality in CKD patients. No clear association with cardiac death was found initially, but sensitivity analysis suggested a possible link.

Sep 29, 2026

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