Dental caries status is associated with arteriosclerosis in patients on hemodialysis
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ORIGINAL ARTICLE
Dental caries status is associated with arteriosclerosis in patients on hemodialysis Taro Misaki1,2 · Akiko Fukunaga3 · Kazuhiko Nakano4 Received: 10 July 2020 / Accepted: 27 August 2020 © Japanese Society of Nephrology 2020
Abstract Background We previously found that worse dental caries status was associated with high pulse pressure among patients on hemodialysis, indicating that such patients might have arteriosclerosis. In this study, we used abdominal computed tomography to evaluate arteriosclerosis in patients on hemodialysis and investigated the association between arteriosclerosis and dental caries status. We also prospectively examined risk factors associated with 2-year prognosis. Methods The dental caries and periodontal disease statuses of 80 patients on hemodialysis were evaluated using the decayed, missing, or filled teeth (DMFT) index, and periodontal pocket depth, respectively. The aortic calcification index was semiquantitatively measured using computed tomography images of the abdominal aorta. Clinical data were also analyzed after all patients on hemodialysis provided written, informed consent to participate in the study. Results Regression analysis demonstrated a significant correlation between the DMFT and aortic calcification indexes. Multiple regression analysis showed that the DMFT index was significantly correlated with the aortic calcification index, following adjustment for age, sex, and dialysis period. Thirteen of the 80 patients died during the 2-year follow-up period; logistic regression analysis showed that mortality rate was significantly associated with the aortic calcification index, but not the DMFT index. However, periodontal pocket depth was not correlated with the aortic calcification index. Conclusion These findings suggest that worse dental caries status could be associated with arteriosclerosis among patients on hemodialysis, which may indirectly affect the prognosis of arteriosclerosis in these patients. Keywords Dental caries · Arteriosclerosis · Hemodialysis
Introduction Several systemic complications of oral disease have recently been reported [1–3]. In particular, several studies have demonstrated associations between oral disease and arteriosclerosis or coronary heart disease [1–8]. In addition,
* Taro Misaki [email protected] 1
Division of Nephrology, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan
2
Department of Nursing, Faculty of Nursing, Seirei Christopher University, Hamamatsu, Shizuoka, Japan
3
Division of Dentistry, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan
4
Division of Oral Infection and Disease Control, Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
arteriosclerosis is an important problem for patients on hemodialysis (HD) [9]. Patients on HD are malnourished [10] and prone to infections [11]; they also have renal anemia [12] and may have diabetes [13]. These patients exhibit arteriosclerosis progression as a result
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