Periodontitis associated with chronic kidney disease among Mexican Americans


  • Support and financial disclosure: This study was supported by NIH/NIDCR Research grant K23DE018689 awarded to E. Ioannidou. This research was also supported by a General Clinical Research Center grant from NIH (M01RR06192) awarded to UCHC.

Dr. Effie Ioannidou, Division of Periodontology, University of Connecticut School of Dental Medicine, 263 Farmington Ave., Farmington, CT 06030-1710. Tel.: 860-679-2367; Fax: 860-679-1027; e-mail: Effie Ioannidou is with the Division of Periodontology, Department of Oral Health and Diagnostic Sciences, University of Connecticut Health Center. Yoshio Hall is with the Division of Nephrology, University of Washington. Helen Swede is with the Department of Community Medicine and Health Care, Division of Epidemiology and Biostatistics, University of Connecticut Health Center. Jonathan Himmelfarb is with the Kidney Research Institute, University of Washington.


Objective: In comparison to non-Hispanic whites, a number of health-care disparities, including poor oral health, have been identified among Hispanics in general and Mexican Americans in particular. We hypothesized that Mexican Americans with chronic kidney disease (CKD) would have higher prevalence of chronic periodontitis compared with Mexican Americans with normal kidney function, and that the level of kidney function would be inversely related to the prevalence of periodontal disease.

Methods: We examined this hypothesis using the National Health and Nutrition Examination Survey 1988-1994 (NHANES III) data set. We followed the American Academy of Periodontology/Center for Disease Control and Prevention case definition for periodontitis. Glomerular filtration rate was estimated using the CKD-Epidemiology equation for Hispanic populations. The classification to CKD stages was based on the National Kidney Foundation Kidney Disease Outcomes Quality Initiative.

Results: Periodontitis prevalence increased across the kidney function groups showing a statistically significant dose–response association (P < 0.001). Mexican Americans with reduced kidney function were twofold more likely to have periodontitis compared with Mexican Americans with normal kidney function after adjusting for potential confounders such as smoking, diabetes, and socioeconomic status. Multivariate adjusted odds ratio for periodontitis significantly increased with 1, 5, and 10 mL/minute estimated glomerular filtration rate reduction from the mean.

Conclusion: This is the first report, to the best our knowledge, that showed an increase of periodontitis prevalence with decreased kidney function in this population.