A causative link between periodontal disease and glomerulonephritis: a preliminary study

Figures & data

Figure 1 The median A) urine protein excretion and B) serum creatinine level before and after the dental procedure (P <0.05).

Table 1 Patients’ demographic and laboratory data (n = 10)1

Patient	Age/sex	Urine protein2(before)	Urine protein2(after)	Serum creatinine (before)	Serum creatinine (after)	PI (%)	PD	GI
1	51/M	2600	160	1.1	1.2	100	7.7	2.7
2	43/F	3000	400	0.7	0.7	70	6.8	1.7
3	30/M	3300	500	0.8	1.2	70	5	1.8
4	35/F	2600	1000	1	1.1	97	5.2	1.8
5	22/F	9800	500	0.6	0.8	90	6.7	2
6	17/F	2500	1500	1	1.2	45	1.5	0.6
7	23/M	4400	1500	0.7	0.8	17	3.7	0.6
8	37/F	3300	800	1	0.8	20	1.7	0.6
9	30/M	2900	3300	0.9	1	25	1.8	0.5
10	28/M	3200	2800	1.6	2.2	27	3.2	0.6

Notes:

1 Urine protein and serum creatinine levels were recorded before and 6 months after the dental treatments;

2 Twenty-four hour urinary protein excretion.

Abbreviations: F, female; GI, gingival index; M, male; PD, periodontal pocket depth; PI, plaque index.

Table 2 Kidney biopsy results of the patients (n = 10)

Patient	Renal biopsy				Serum C3 (mg/dL)	Serum C4 (mg/dL)	Serum CH50 (%)
	LM	IF	Interstitial inflammation	Fibrosis
1	MP	IgM+, C3++	Mild mononuclear infiltration	Mild	120	20	101
2	MP	C3++	Mild patchy mononuclear infiltration	None	104	21	110
3	MP	IgM+, C3+	Mild mononuclear infiltration	None	118	18	150
4	MP	IgG++, IgA+	Moderate patchy mixed inflammation	None	140	22	110
5	MP	IgG++, C3++	Mild patchy inflammation	Mild	88	30	102
6	MP	IgA+	None	None	99	27	110
7	MCD	Negative	Mild mononuclear infiltration	None	127	30	120
8	MPGN	IgM+, C3+	Mild patchy mononuclear infiltration	Mild	118	33	171
9	MPGN	IgA+	Mild mononuclear infiltration	Mild	150	35	118
10	MP, FSGS	IgM+	Moderate patchy mononuclear infiltration	Mild	105	28	160

Note: Serum complement levels prior to the dental procedures are also included. The normal range of C3 is 90–180 mg/dL, C4 is 10–40 mg/dL, and CH50 is 70%–150%.

Abbreviations: C3, C3 complement; C4, C4 complement; CH50, total hemolytic complement; FSGS, focal segmental glomerulosclerosis; IF, immunofluorescence staining; IgA, immunoglobulin A; IgG, immunoglobulin G; IgM, immunoglobulin M; LM, light microscopy; MCD, minimal change disease; MP, mesangioproliferative glomerulonephritis; MPGN, membranoproliferative glomerulonephritis.

Table 3 Oral findings and dental treatments in the patients (n = 10)

Patient	Oral findings1	Dental treatments	CRP2(before)	CRP2(after)
1	Severe periodontitis	OHI, PeriT, EXT	+3	Negative
2	Severe periodontitis, periapical infections	OHI, PeriT, EXT, RCT	+3	Negative
3	Periodontitis, ill-prepared RCT	OHI, PeriT, re-RCT	+1	Negative
4	Periodontitis, infectious roots remaining	OHI, PeriT, EXT	+1	+1
5	Periodontitis, active dental abscess	OHI, PeriT, EXT	+3	Negative
6	Gingivitis, no active infectious foci	OHI	+1	+1
7	Gingivitis, no active infectious foci	OHI	Negative	Negative
8	Gingivitis, ill-prepared RCT	OHI, re-RCT	+1	Negative
9	Gingivitis, no active infectious foci	OHI	+1	Negative
10	Gingivitis, periapical infections	OHI, EXT	+2	Negative

Notes: CRP levels before and after dental procedures are also included.

1 Oral findings have been recorded prior to the dental treatments;

2 CRP levels have been measured before and 6 months after periodontal therapy.

Abbreviations: CRP, C-reactive protein; EXT, tooth extraction; OHI, oral hygiene instruction; PeriT, periodontal treatments; RCT, root canal therapy.