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Kidney Week

Abstract: FR-PO1163

The Impact of Periodontitis on Recipient Outcomes After Kidney Transplantation

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Kim, Myung-Gyu, Korea University Anam Hospital, Seoul, Seoul, Korea (the Republic of)
  • Min, Hyeonjin, Korea University Anam Hospital, Seoul, Seoul, Korea (the Republic of)
  • Oh, Sewon, Korea University Anam Hospital, Seoul, Seoul, Korea (the Republic of)
  • Jo, Sang-Kyung, Korea University Anam Hospital, Seoul, Seoul, Korea (the Republic of)
Background

Periodontitis has a high prevalence in patients with chronic kidney disease and has been reported to increase systemic inflammations and cardiovascular risks. Although dental care is usually recommended prior to transplantation due to potential for serious infection, little is known about impact of periodontitis on transplant outcomes. The purpose of this study was to examine whether periodontitis before KT affects post-KT recipient outcomes.

Methods

This was a single center, retrospective study including KT recipients from April 2008 to October 2018. The panoramic radiographs at pre-KT work up were analyzed by a dentist with severity of periodontitis graded according to new classification system developed in 2017.

Results

One hundred and sixty-six recipients who received pre-KT dental examination were divided into 3 groups according to 1st, 2nd, 3rd and 4th-stage periodontitis; group1 (1st and 2nd stage, 28.9%), group2 (3rd stage, 35.8%), and group3 (4th-stage, 22.6%) respectively. Seventy-seven patients (46.4%) with periodontitis received treatments such as scaling or surgical extraction before KT. Advanced stage periodontitis patients were more likely to be older, obese, smoker and had higher prevalence of diabetes. However, pre-transplant immunological variables or immunosuppression were not different according to periodontitis grades. The mean follow-up period is 4.16 years. Advanced stage periodontitis without treatment was associated with significantly increased risk of CMV and BKV infection. However, rate of acute T cell mediated rejection was significantly lower in patients with advanced stage periodontitis. eGFR measured at 36 months after KT was significantly higher in patients with advanced periodontitis (p=0.016) and this association was evident only in younger (<50yrs), male and non-diabetic patients. Multivariate logistic regression analysis showed that low stage of periodontitis and the use of cyclosporine were independent predictors for lower eGFR at 36 months.

Conclusion

These results suggest that pre-transplant periodontitis could be a manifestation of systemic inflammation and altered immune function in patients with end-stage renal disease and may affect long-term post-transplant outcomes. Impact of periodontitis or its treatment on transplant outcomes needs to be further clarified.