Graziani F, Cei S, La Ferla F, Vano M, Gabriele M, Tonetti M. Effects of non-surgical periodontal therapy on glomerular filtration rate of the kidney: an exploratory trial. J Clin Periodontol 2010; 37: 638–643. doi: 10.1111/j.1600-051X.2010.01578.x.
Objective: To determine whether non-surgical periodontal treatment (PT) would exert, in subjects with generalized chronic periodontitis (GCP), some beneficial effect on renal function as indicated by surrogate measures of the glomerular filtration rate (GFR).
Material and Methods: Twenty GCP systemically healthy subjects were treated with PT. Serum samples were collected at baseline and 1 day, 7, 30, 90 and 180 days after treatment. GFR was evaluated using cystatin C, a serum marker and modification of diet in renal disease (MDRD), an equation involving creatinine, urea and albumin. Serum markers of systemic inflammation such as C-reactive protein (CRP), D-dimer, serum amyloid A (SAA) and fibrinogen were also assessed.
Results: The cystatin C level decreased significantly from baseline to the end of the trial (p<0.01). Conversely, MDRD did not vary. A significant inflammatory reaction was produced by PT in the short term. Greater increases were noted for CRP and SAA within 24 h (p<0.001 versus baseline), while d-dimer (p<0.05) and fibrinogen (p<0.01) showed mild variations. The values of inflammatory markers were normalized after 30 days.
Conclusions: GFR, as assessed by cystatin C levels, may be positively affected by PT. Because of the exploratory nature of this trial, further research is needed to investigate this preliminary finding.