Associação entre periodontite e níveis séricos de ferritina em pacientes sob terapia de hemodiálise

Abstract

Periodontitis has an important systemic inflammatory impact, which seems to exacerbate the chronic kidney disease (CKD). Acute-phase reactants are possible mediators of this association. The aim of the present study was to evaluate the association between peridontitis and ferritin levels in patients undergoing hemodialysis therapy. Furthermore, to determine the strenght of association between periodontitis combined with untreated caries and ferritin levels. A cross-sectional study evaluated 167 end-stage renal disease patients. Calibrated examiners performed the complete periodontal examination and the decayed, missing and filled teeth index (DMFt). The burden of oral disease was determined by the interaction between severe periodontitis and untreated caries. Blood samples were collected from the arterial fistula of the vascular access and analyzed for ferritin levels. Ferritin was also categorized at 300ng/mL. Linear regression and Poisson analyzes were used to verify the association between oral condition and ferritin. Ferritin levels were significantly higher in patients with severe generalized periodontitis (356.80±227.37 ng/mL) and increased when combined with untreated caries (456.17±242.25 ng/ml) (p<0.05). In the adjusted analysis, patients with generalized periodontitis combined with untreated caries were aproximately 2.6 times more likely (OR = 2.59; CI 95% 1.39-4.83) to have elevated serum ferritin concentrations. Therefore, severe periodontitis is associated with higher serum ferritin levels and when combined with untreated caries, these levels seem to worsen in end-stage renal disease patients. The finding that oral conditions may negatively influence the general health of this population is of high importance, and favors the development of future actions and strategies in oral health.