Relationship Between Periodontal Disease and Serum Factors in Patients Undergoing Hemodialysis

Narges Naghsh1, Negar Kanuni Sabet2, Forozan Vahidi1, Ahmad Mogharehabed1, Jaber Yaghini1, *
1 Department of Periodontology, Dental Implants Research Center, School of dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
2 Department of Periodontology, Torabinejad research center, School of dentistry, Isfahan University of Medical Sciences, Isfahan, Iran

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© 2017 Naghsh et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the School of Dentistry, Isfahan University of Medical Sciences, Hezar jrib Street, Isfahan, Iran, Tel: 00989133050508; E-mail:



Chronic renal disease is a common condition with several recognized risk factors. Periodontal disease is a recently suggested risk factor for renal disease. We aimed to assess the relationship between periodontal disease and several serum factors in patients undergoing hemodialysis.


This descriptive cross-sectional study was conducted on 57 patients undergoing hemodialysis. Periodontal examination was done by measuring the mean Pocket Depth (PD), Silness-Löe Plaque Index (PI), Ainamo and Bay Bleeding On Probing (BOP), Löe and Silness Gingival Index (GI) and Clinical Attachment Loss (CAL). Serum levels of albumin, calcium, phosphorus, hemoglobin, ferritin and creatinine were measured via a routine blood test. Cystatin C was separately measured. Data were analyzed using independent t-test, Pearson’s correlation coefficient, chi square test and Mann Whitney test (alpha=0.05).


37 men and 20 women were evaluated. Of these, 26.3% had periodontitis and 73.7% had gingivitis. Serum level of albumin (P=0.02) and ferritin (P=0.043) in patients with periodontitis was significantly higher than that in patients with gingivitis. The serum level of creatinine (P=0.02), cystatin C (P=0.013), calcium (P=0.046) and phosphorus (P=0.037) had a significant correlation with severity of periodontitis and increase in CAL.


Increase in the serum levels of albumin and ferritin was related to the progression of gingivitis to periodontitis. Also, the serum levels of creatinine, cystatin C, calcium and phosphorus increased with an increase in CAL.

Keywords: Periodontal disease, Dialysis, Serum factors, Cystatin C, Clinical attachment loss (CAL), Gingival index (GI).