The Effect of Non-surgical Periodontal Treatment in the Renal Function of Patients With Chronic Kidney Disease: RCT
The Effect of Non-surgical Periodontal Treatment in the Renal Function of Patients With Chronic Kidney Disease: A Randomized Clinical Trial
Periodontal disease is a bacterially-induced inflammation. As such, it can become a point of entry of bacteria, toxins and cytokines into the systemic blood circulation, thus adversely affecting the function of kidneys. This is turn can aggravate the condition of patients with CKD.
The study hypothesis is that periodontal therapy can improve renal function in patients with CKD and lower the blood levels of markers for systemic inflammation.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
-
Athens, Greece, 11527
- University of Athens, Dental School, Department of Periodontology
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Chronic Kidney Disease (Stage II, III, IV)
- At least 12 teeth present in the oral cavity
- Moderate to severe chronic periodontitis, which is defined as: at least 8 surfaces with periodontal pocket depth (PPD) ≥5mm and at least 4 surfaces with Clinical Attachment Loss (CAL) ≥4mm, distributed in at least two quadrants.
Exclusion Criteria:
- Patients that have had a renal transplant or undergoing dialysis
- Acute infections or use of antibiotics in the past 3 months.
- Auto-immune diseases, conditions that cause immunosuppression or use of immunosuppressant medication.
- Systemic conditions that require antibiotic prophylaxis for routine periodontal therapy.
- Non-surgical periodontal therapy in the past 6 months or surgical periodontal therapy in the past 12 months.
- Use of medication that can cause gingival hyperplasia such as cyclosporine or fenintoin.
- Myocardial infarction or cerebral vascular incident in the past 12 months or uncontrolled angina.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
No Intervention: Control
Full mouth supra-gingival debridement using hand instruments and ultrasonic scalers, in one session. Patient motivation and oral hygiene instructions Review and prophylaxis at 1 month, 3 months and 6 months after initial treatment session. Full mouth periodontal therapy provided at the end of the 6month period (supra and sub- gingival full mouth scaling) |
|
|
Active Comparator: Test/ Non-surgical Periodontal Therapy
Full mouth periodontal therapy (sub and supra- gingival debridement) provided under local anaesthesia in two half-mouth sessions. Review and prophylaxis 1 month, 3 months and 6 months after the end of the initial therapy. |
Non-surgical Periodontal Therapy provided in two sessions, one for the right half and one for the left half of the dentition.
Treatment sessions are provided within one week.
No antibiotics or other adjunctive medications are to be used
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
eGFR
Time Frame: 6 months
|
Estimated Glomerular Filtration Rate
|
6 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Level of IgG antibodies in serum against periodontal pathogens
Time Frame: 6 months
|
Serum samples will be screened for the presence of IgG antibodies against the below mentioned periodontal pathogens, using the "checkerboard immunoblotting" method: Porphyromonas gingivalis, Prevotella intermedia, Prevotella nigrescens, Bacteroides forsythus, Treponema denticola, Fusobacterium nucleatum, Actinobacillus actinomycetemcomitans, Campylobacter rectus, Eikenella corrodens, Peptostreptococcus micros, Veillonella parvula, Capnocytophaga ochracea, Streptococcus intermedius, Streptococcus sanguis και Streptococcus oralis.per |
6 months
|
|
Composition of dental plaque
Time Frame: 6 months
|
Samples of subgingival plaque will be assessed using DNA probes according to the "checkerboard DNA- DNA hybridization" method.
DNA probes will be used against the following bacteria: Porphyromonas gingivalis, Prevotella intermedia, Prevotella nigrescens, Bacteroides forsythus, Treponema denticola, Fusobacterium nucleatum, Actinobacillus actinomycetemcomitans, Campylobacter rectus, Eikenella corrodens, Peptostreptococcus micros, Veillonella parvula, Capnocytophaga ochracea, Streptococcus intermedius, Streptococcus sanguis and Streptococcus oralis
|
6 months
|
|
CRP
Time Frame: 6 months
|
C-Reactive Protein level
|
6 months
|
|
d-8-iso prostaglandin F2a
Time Frame: 6 months
|
d-8-iso prostaglandin F2a
|
6 months
|
|
HbA1C
Time Frame: 6 months
|
Glycosylated Hemoglobin
|
6 months
|
|
FMD / NMD
Time Frame: 6 months
|
Flow Mediated Dialation, Nitroglycerin Mediated Dialation, Assessment of Endothelial Dysfunction
|
6 months
|
|
PWV
Time Frame: 6 months
|
Pass Wave Velocity, Assessment of Endothelial Dysfunction
|
6 months
|
|
AIx
Time Frame: 6 months
|
Augmentaion Index
|
6 months
|
|
Cholesterol levels
Time Frame: 6 months
|
Chloesterol Levels
|
6 months
|
|
Ca
Time Frame: 6 months
|
Serum Calcium
|
6 months
|
|
P
Time Frame: 6 months
|
Serum Phosphate
|
6 months
|
|
Triglycerides
Time Frame: 6 months
|
Serum triglycerides
|
6 months
|
|
LDL / HDL
Time Frame: 6 months
|
Low / High Density Lipoprotein
|
6 months
|
|
Serum Urea
Time Frame: 6 months
|
Serum Urea
|
6 months
|
|
Serum Albumin
Time Frame: 6 months
|
Serum Albumin
|
6 months
|
|
Urine Albumin
Time Frame: 6 months
|
Urine Albumin
|
6 months
|
|
Urine Creatinine
Time Frame: 6 months
|
Urine Creatinine
|
6 months
|
|
Cr/Alb ratio
Time Frame: 6 months
|
Urine Creatinine / Albumin Ration
|
6 months
|
Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Periodontal Indices (PPD, CAL, BOP, GI)
Time Frame: 6 months
|
Assessment of the periodontal status
|
6 months
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Phoebus N Madianos, PhD, University of Athens
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Urogenital Diseases
- Periodontal Diseases
- Mouth Diseases
- Stomatognathic Diseases
- Pathologic Processes
- Male Urogenital Diseases
- Urologic Diseases
- Female Urogenital Diseases
- Female Urogenital Diseases and Pregnancy Complications
- Chronic Disease
- Disease Attributes
- Renal Insufficiency
- Periodontitis
- Kidney Diseases
- Renal Insufficiency, Chronic
Other Study ID Numbers
Other Study ID Numbers
- 143
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