Effects of non-surgical periodontal therapy on systemic inflammation and metabolic markers in patients undergoing haemodialysis and/or peritoneal dialysis: a systematic review and meta-analysis
Background: This systematic review aimed to investigate whether non-surgical periodontal therapy (NSPT) can reduce systemic inflammatory levels and improve metabolism in patients undergoing haemodialysis (HD) and/or peritoneal dialysis (PD). Methods: Electronic databases (PubMed, EMBASE, CENTRAL, CNKI, and WFPD) were searched for randomized controlled trials (RCTs) performed through July 2019. The risk of bias within studies was assessed with the Cochrane Collaboration’s risk assessment tool. The systemic inflammatory and metabolic outcomes included the highly sensitive C-reactive protein (hs-CRP), interleukin 6 (IL-6), tumour necrosis factor-a (TNF-a), the albumin (Alb), and lipid metabolite levels Meta-analyses (MAs) were performed to calculate the overall effect size where appropriate. Results: Five RCTs were included in this study. Compared with untreated periodontitis groups, the dialysis patients after NSPT significantly showed decreased hs-CRP levels at less than or equal to 2 months (standardized mean difference: -1.53, 95% confidence interval -2.95 to -0.11). No significant difference was found in IL-6 and Alb levels following NSPT at either the 3- or 6- month follow-ups. No MAs could be performed on the TNF-a level and the lipid metabolic markers. Conclusions: NSPT can moderately reduce serum hs-CRP levels in HD and/or PD patients, but did not significantly change IL-6 or Alb levels. For TNF-a and lipid metabolism markers, no sufficient evidence supports that these levels are changed after NSPT. Additional scientific research is necessary to assess the effects of NSPT on systemic inflammation and metabolic parameters in dialysis patients.
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Posted 10 Jan, 2020
On 22 Jan, 2020
On 10 Jan, 2020
On 07 Jan, 2020
On 06 Jan, 2020
On 06 Jan, 2020
On 26 Dec, 2019
Received 13 Dec, 2019
Received 07 Dec, 2019
On 03 Dec, 2019
Invitations sent on 28 Nov, 2019
On 28 Nov, 2019
On 27 Nov, 2019
On 26 Nov, 2019
On 26 Nov, 2019
On 27 Oct, 2019
Received 25 Oct, 2019
Received 23 Oct, 2019
On 13 Oct, 2019
On 05 Oct, 2019
Invitations sent on 04 Oct, 2019
On 23 Sep, 2019
On 22 Sep, 2019
On 22 Sep, 2019
Effects of non-surgical periodontal therapy on systemic inflammation and metabolic markers in patients undergoing haemodialysis and/or peritoneal dialysis: a systematic review and meta-analysis
Posted 10 Jan, 2020
On 22 Jan, 2020
On 10 Jan, 2020
On 07 Jan, 2020
On 06 Jan, 2020
On 06 Jan, 2020
On 26 Dec, 2019
Received 13 Dec, 2019
Received 07 Dec, 2019
On 03 Dec, 2019
Invitations sent on 28 Nov, 2019
On 28 Nov, 2019
On 27 Nov, 2019
On 26 Nov, 2019
On 26 Nov, 2019
On 27 Oct, 2019
Received 25 Oct, 2019
Received 23 Oct, 2019
On 13 Oct, 2019
On 05 Oct, 2019
Invitations sent on 04 Oct, 2019
On 23 Sep, 2019
On 22 Sep, 2019
On 22 Sep, 2019
Background: This systematic review aimed to investigate whether non-surgical periodontal therapy (NSPT) can reduce systemic inflammatory levels and improve metabolism in patients undergoing haemodialysis (HD) and/or peritoneal dialysis (PD). Methods: Electronic databases (PubMed, EMBASE, CENTRAL, CNKI, and WFPD) were searched for randomized controlled trials (RCTs) performed through July 2019. The risk of bias within studies was assessed with the Cochrane Collaboration’s risk assessment tool. The systemic inflammatory and metabolic outcomes included the highly sensitive C-reactive protein (hs-CRP), interleukin 6 (IL-6), tumour necrosis factor-a (TNF-a), the albumin (Alb), and lipid metabolite levels Meta-analyses (MAs) were performed to calculate the overall effect size where appropriate. Results: Five RCTs were included in this study. Compared with untreated periodontitis groups, the dialysis patients after NSPT significantly showed decreased hs-CRP levels at less than or equal to 2 months (standardized mean difference: -1.53, 95% confidence interval -2.95 to -0.11). No significant difference was found in IL-6 and Alb levels following NSPT at either the 3- or 6- month follow-ups. No MAs could be performed on the TNF-a level and the lipid metabolic markers. Conclusions: NSPT can moderately reduce serum hs-CRP levels in HD and/or PD patients, but did not significantly change IL-6 or Alb levels. For TNF-a and lipid metabolism markers, no sufficient evidence supports that these levels are changed after NSPT. Additional scientific research is necessary to assess the effects of NSPT on systemic inflammation and metabolic parameters in dialysis patients.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5