Effect of periodontitis treatment on renal function in chronic kidney disease patients: a systematic review and meta-analysis
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Abstract
To evaluate the effect of non-surgical periodontal therapy (NSPT) on renal function and systemic inflammatory markers in patients with chronic kidney disease (CKD). A systematic literature search was conducted in PubMed, SCOPUS, EMBASE, and the Cochrane Library for articles published up to October 2025, strictly following PRISMA guidelines. The protocol was registered in PROSPERO (CRD42021232030). Eligible studies included clinical trials and before-after studies evaluating the effect of NSPT on renal parameters (eGFR, serum creatinine, BUN, UACR) in patients with CKD. Meta-analyses were performed using random-effects models and stratified by CKD stage (pre-dialysis vs. dialysis). Ten studies (seven before-after studies and three randomized controlled trials) met the inclusion criteria. The overall pooled meta-analysis indicated that NSPT did not significantly improve traditional renal filtration parameters. In subgroup analyses, pre-dialysis patients demonstrated a modest, but non-significant trend toward improved eGFR. Among dialysis patients, serum creatinine and eGFR showed no significant improvement and occasionally increased, which may paradoxically reflect altered nutritional status rather than a deterioration in renal filtration. Although NSPT does not result in statistically significant improvements in traditional renal filtration markers, it effectively reduces systemic inflammatory burden in both pre-dialysis and dialysis patients. Integrating periodontal care into multidisciplinary CKD management remains crucial for minimizing inflammation-driven cardiovascular risks. Future robust, long-term trials targeting pre-dialysis populations and utilizing highly sensitive novel biomarkers are warranted to evaluate potential slowing of CKD progression.
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