The odontogenic-related microinflammation in patients with chronic kidney disease

Figures & data

Table 1. Characteristics of 63 hypertensive patients with chronic kidney disease and odontogenic infection.

Gender:	30 women, 33 men
Age [years]	41 ± 15 (range 17–69)
BMI [kg/m^2]	28.1 ± 5.4
Duration of arterial hypertension [years]	5.9 ± 6.8 (max. 30)
Hypertensive retinopathy [%]	I°−23.5
	II° or III°−43.1
Number of antihypertensive drugs	2.7 ± 1.4
ACE inhibitors and ARB [%]	82.5
Calcium channel blockers [%]	41.3
Beta blockers [%]	54.0
Alpha blockers [%]	12.7
Diuretics [%]	46.0
Other antihypertensive drugs [%]	9.5
Systolic blood pressure on antihypertensive therapy [mmHg]	136 ± 14
Diastolic blood pressure on antihypertensive therapy [mmHg]	85 ± 8
Maximum SBP [mmHg]	153 ± 21
Maximum DBP [mmHg]	94 ± 13
Patients with diabetes mellitus type 2 [%]	9.5
Duration of diabetes therapy [years]	4 ± 4 (range 1–8)
Serum creatinine concentration [µmol/l]	122.6 ± 74.2
Estimated glomerular filtration rate [ml/min/1.73m^2]	67.2 ± 26.1
Causes of chronic kidney disease [n]
Hypertensive nephropathy	11
Chronic glomerulonephritis	10
Diabetic nephropathy	6
Interstitial nephropathy	2
Ischemic nephropathy	1
Unknown	33
Chronic kidney disease (CKD) stages:
CKD 1 (eGFR >90 ml/min)	9 (14.3%)
CKD 2 (eGFR 60–89 ml/min)	33 (52.4%)
CKD 3 (eGFR 30–59 ml/min)	14 (22.2%)
CKD 4 (eGFR 15–29 ml/min)	7 (11.1%)

BMI, body mass index; ACE, angiotensin-converting enzyme; ARB, angiotensin receptor blockers.

Table 2. Lipid profiles, intima-media thickness (IMT), and echocardiography data in hypertensive patients with odontogenic infection foci and chronic kidney disease.

	After root canal therapy I (n = 12)	Pulp necrosis II (n = 7)	Periapical lesions III (n = 22)	Periodontitis IV (n = 8)	Reference subgroup V (n = 14)
Age [years]	42* (31–53)	49* (37–60)	42* (37–48)	56** (49–63)	26 (21–31)
BMI [kg/m^2]	27.8 (25.0–30.5)	29.1 (23.0–35.1)	27.6 (25.3–29.8)	29.5 (25.7–33.4)	27.9 (23.7–32.1)
eGFR [ml/min/1.73m^2]	65.4 (44.7–86.2)	60.8 (45.0–76.7)	68.0 (55.2–80.8)	51.3 (36.9–65.8)	79.8 (68.9–90.7)
Cholesterol [mmo/L]	4.78 (4.19–5.38)	6.08* (5.14–7.01)	4.96 (4.48–5.44)	5.89* (4.68–7.11)	4.10 (3.41–4.79)
LDL-cholesterol [mmol/L]	2.92 (2.18–3.65)	4.00* (3.10–4.89)	2.87 (2.47–3.28)	3.02 (2.13–3.90)	2.10 (1.63–2.58)
HDL-cholesterol [mmol/L]	1.03 (0.81–1.25)	1.16 (0.87–1.46)	1.19 (0.96–1.42)	1.03 (0.71–1.34)	1.21 (1.00–1.43)
Triglycerides [mmol/L]	1.64 (1.08–2.19)	2.02 (1.18–2.86)	1.88 (1.56–2.19)	3.16** (2.40–3.92)	1.46 (0.96–1.97)
IMT [mm]	0.58 (0.41–0.74)	0.66 (0.44–0.88)	0.62 (0.53–0.72)	0.82* (0.66–0.98)	0.55 (0.45–0.66)
IVS [mm]	10.1 (9.0–11.2)	10.6 (9.5–11.7)	10.5 (9.7–11.3)	9.9 (8.7–11.2)	9.4 (8.3–10.5)
LVM [g]	195 (162–228)	195 (158–232)	211 (151–270)	183 (138–227)	155 (120–188)
EF [%]	56 (50–61)	54 (45–60)	52 (49–55)	49 (42–55)	55 (52–58)

BMI, body mass index; eGFR, estimated glomerular filtration rate; IVS, interventricular septal thickness; LVM, left ventricular mass; EF, left ventricular ejection fraction; statistical significance *p < 0.01 **p < 0.001 versus reference subgroup.

Figure 1. Plasma concentration of tumour necrosis factor α in hypertensive patients with odontogenic infection foci and chronic kidney disease: I—patients after proper root canal therapy, with no periapical lesions, II—patients with pulp necrosis, III—patients with asymptomatic periapical lesions, IV—patients with periodontal disease, and reference subgroup with health teeth (statistical significance vs. reference subgroup *p = 0.02; **p = 0.001).

Figure 2. Plasma concentration of interleukin 6 in hypertensive patients with odontogenic infection foci and chronic kidney disease: I—patients after proper root canal therapy, with no periapical lesions, II—patients with pulp necrosis, III—patients with asymptomatic periapical lesions, IV—patients with periodontal disease, and reference subgroup with health teeth (statistical significance vs. reference subgroup **p = 0.001).

Table 3. Plasma concentration of inflammatory markers in hypertensive patients with odontogenic infection foci and chronic kidney disease.

	After root canal therapy I (n = 12)	Pulp necrosis II (n = 7)	Periapical lesions III (n = 22)	Periodontitis IV (n = 8)	Reference subgroup V (n = 14)
CRP>2 mg/L [%]	25.0	85.7^	22.7	37.5	28.6
hsCRP [mg/L]	3.99 (0.46–7.51)	5.11 (2.83–7.40)	3.69 (1.85–5.53)	3.20 (1.57–4.82)	4.68 (1.89–7.46)
IL-6 [pg/mL]	2.02 (0.67–3.37)	3.15** (0.39–6.69)	1.32 (1.01–1.63)	2.40** (1.36–3.44)	0.91 (0.63–1.18)
IL-1β [pg/mL]	0.98 (0.47–2.42)	0.48 (0.11–0.86)	0.53 (0.37–0.68)	0.47 (0.24–0.70)	0.40 (0.20–0.60)
TNF-α [pg/mL]	2.14 (0.15–4.14)	1.18* (0.54–1.82)	2.40 (1.65–3.16)	4.99** (2.26–7.71)	2.44 (1.84–3.03)
IFNγ [pg/mL]	2.51 (1.00–4.01)	0.75 (0.13–1.37)	1.64 (0.67–2.61)	1.93 (0.22–3.64)	1.12 (0.21–2.04)

CRP, C-reactive protein; IL-6, interleukin 6; IL-1β, interleukin 1β; TNF-α, tumour necrosis factor-α; INF-γ, interferon γ; statistical significance ^p = 0.04; *p = 0.02; **p = 0.001 versus reference subgroup.