Exploring the links between periodontal health and cardio-renal health in patients with chronic kidney disease

Sharma, Praveen ORCID: 0000-0001-6435-4842 (2019). Exploring the links between periodontal health and cardio-renal health in patients with chronic kidney disease. University of Birmingham. Ph.D.

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Abstract

Chronic kidney disease (CKD) is a highly prevalent, chronic, non-communicable disease (NCD). CKD is associated with high morbidity and mortality, particularly from cardio-vascular events. Recently, the role of systemic inflammatory/oxidative stress burden in the morbidity and mortality associated with CKD is being appreciated. Periodontitis, another highly prevalent NCD, is caused by bacteria accumulating around the gingival margin of teeth and leads to local inflammation and destruction of the supporting tissues of teeth. There is a growing appreciation of the role of periodontitis in adding to the systemic inflammatory/oxidative stress burden. Periodontitis may represent an occult, modifiable source of such burden in patients with CKD. The seven manuscripts in this thesis aim to shed light on the relationship between periodontitis and CKD with a view of elucidating the causal mechanisms underpinning this relationship. The first three manuscripts demonstrate an association between periodontitis and incident cardio-vascular disease, systemic health and wellbeing, respectively. The final four manuscripts demonstrate the associations between mortality and periodontitis in patients with CKD, the association between periodontitis and CKD, an outline of an on-going, pilot RCT investigating the effects of one treatment of periodontitis on the cardio-renal health of patients with CKD and finally the causal mechanisms underpinning the associations between periodontitis and CKD are explored using path analysis structural equation modelling.

Type of Work:

Thesis (Doctorates > Ph.D.)

Award Type:

Doctorates > Ph.D.

Supervisor(s):