The influence of chronic periodontitis on serum TNF-α, IL-6 and hs-CRP concentrations, and function of graft and survival of kidney transplant recipients


Corresponding author: Edward Franek, MD, Department of Internal Medicine, Endocrinology and Diabetology, Central Clinical Hospital MSWiA, ul. Woloska 137, Warszawa 02-507, Poland.
Tel.: +48-22-5081405; fax: +48-22-5081400;


Abstract:  Objective:  The aim of the study is to analyze whether chronic periodontitis (CP) influences serum tumor necrosis factor (TNF)-α, interleukin (IL)-6, and high-sensitivity C-reactive protein (hs-CRP) concentrations in renal transplant recipients and patients or graft survival.

Background:  CP is associated both with higher serum concentrations of cytokines and CRP and high cardiovascular risk.

Methods:  One hundred and seventeen patients with a transplanted kidney (Tx) were divided according to the Community Periodontal Index of Treatment Needs (CPITN) into two subgroups: TxP+: severe CP (CPITN 3-4) and TxP−: no or moderate CP (CPITN 0-2). The control group (C) consisted of 36 subjects with no kidney disease and with no or moderate CP (CPITN 0-2).

Results:  hs-CRP concentration was higher in TxP+ than in TxP− patients [2.0 mg/L (0.7–4.4) vs. 0.9 mg/L (0.3–1.9), p = 0.006]. There were no differences in serum TNF-α and IL-6 between TxP+ and TxP−. Significant positive correlation between CPITN score and hs-CRP concentration was found both in Tx and C. The hazard ratio of death was 7.17 (1.4–76.4) for TxP+ patients. CP status did not increase the risk of graft loss or doubling of serum creatinine.

Conclusions:  Severe CP is associated with increased serum hs-CRP concentration in patients after kidney transplantation. Severe periodontitis seems to increase the risk of patients’ death after kidney transplantation.