Serum markers of periodontal disease status and inflammation in hemodialysis patients

Margaret A. Rahmati, Ronald G. Craig, Peter Homel, George Kaysen, Nathan W. Levin

Research output: Contribution to journalArticle

91 Citations (Scopus)

Abstract

Background: Hemodialysis (HD) patients face a 25% annual mortality rate, with 50% of reported deaths attributed to cardiovascular disease. All-cause and cardiovascular mortality correlate with such acute-phase proteins as C-reactive protein (CRP). Hepatic CRP synthesis is upregulated by inflammation; however, elevated CRP values frequently are found in the absence of apparent infection or inflammation. Because destructive periodontal diseases have been associated with elevated CRP levels, we questioned whether destructive periodontal diseases could contribute to elevated CRP values in HD populations. Methods: Sera from 86 consecutive dentate HD patients were assayed for levels of immunoglobulin G (IgG) antibody to six periodontal species by means of an enzyme-linked immunosorbent assay. Results: CRP values for the subject population ranged from less than 6.9 to 159 mg/L (median, 8.2 mg/L). Univariate comparisons between subjects with or without elevated CRP levels (>10 mg/L) showed that CRP level elevation was associated significantly (P < 0.05) with greater doses of human recombinant erythropoietin and lower levels of hemoglobin, serum iron, transferrin saturation (TSat), albumin averaged over the 3 preceding months, total cholesterol, and triglycerides. Log serum IgG antibody levels to Porphyromonas gingivalis also were significantly greater in the group with elevated CRP levels (P = 0.013). Subsequent multivariate logistic regression showed that log serum antibody levels to P gingivalis remained significant (P = 0.02) after controlling for nonperiodontal sources of elevated CRP, hemoglobin, TSat, and triglyceride values. Conclusion: These results suggest that elevated levels of IgG antibody to bacterial species associated with destructive periodontal diseases are associated with elevated CRP values in HD populations.

Original languageEnglish (US)
Pages (from-to)983-989
Number of pages7
JournalAmerican Journal of Kidney Diseases
Volume40
Issue number5
DOIs
StatePublished - Nov 1 2002
Externally publishedYes

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Periodontal Diseases
C-Reactive Protein
Renal Dialysis
Biomarkers
Inflammation
Immunoglobulin G
Transferrin
Serum
Antibodies
Hemoglobins
Triglycerides
Bacterial Antibodies
Population
Porphyromonas gingivalis
Mortality
Acute-Phase Proteins
Erythropoietin
Protein C
Albumins
Cardiovascular Diseases

Keywords

  • Acute phase
  • Albumin
  • C-Reactive protein (CRP)
  • Iron
  • Porphyromonas gingivalis

ASJC Scopus subject areas

  • Nephrology

Cite this

Serum markers of periodontal disease status and inflammation in hemodialysis patients. / Rahmati, Margaret A.; Craig, Ronald G.; Homel, Peter; Kaysen, George; Levin, Nathan W.

In: American Journal of Kidney Diseases, Vol. 40, No. 5, 01.11.2002, p. 983-989.

Research output: Contribution to journalArticle

Rahmati, Margaret A. ; Craig, Ronald G. ; Homel, Peter ; Kaysen, George ; Levin, Nathan W. / Serum markers of periodontal disease status and inflammation in hemodialysis patients. In: American Journal of Kidney Diseases. 2002 ; Vol. 40, No. 5. pp. 983-989.
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AB - Background: Hemodialysis (HD) patients face a 25% annual mortality rate, with 50% of reported deaths attributed to cardiovascular disease. All-cause and cardiovascular mortality correlate with such acute-phase proteins as C-reactive protein (CRP). Hepatic CRP synthesis is upregulated by inflammation; however, elevated CRP values frequently are found in the absence of apparent infection or inflammation. Because destructive periodontal diseases have been associated with elevated CRP levels, we questioned whether destructive periodontal diseases could contribute to elevated CRP values in HD populations. Methods: Sera from 86 consecutive dentate HD patients were assayed for levels of immunoglobulin G (IgG) antibody to six periodontal species by means of an enzyme-linked immunosorbent assay. Results: CRP values for the subject population ranged from less than 6.9 to 159 mg/L (median, 8.2 mg/L). Univariate comparisons between subjects with or without elevated CRP levels (>10 mg/L) showed that CRP level elevation was associated significantly (P < 0.05) with greater doses of human recombinant erythropoietin and lower levels of hemoglobin, serum iron, transferrin saturation (TSat), albumin averaged over the 3 preceding months, total cholesterol, and triglycerides. Log serum IgG antibody levels to Porphyromonas gingivalis also were significantly greater in the group with elevated CRP levels (P = 0.013). Subsequent multivariate logistic regression showed that log serum antibody levels to P gingivalis remained significant (P = 0.02) after controlling for nonperiodontal sources of elevated CRP, hemoglobin, TSat, and triglyceride values. Conclusion: These results suggest that elevated levels of IgG antibody to bacterial species associated with destructive periodontal diseases are associated with elevated CRP values in HD populations.

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