Title

Tooth Loss Strongly Associates With Malnutrition in Chronic Kidney Disease

Authors

Efthimia Effie Ioannidou, University of Connecticut School of Medicine and Dentistry
Helen Swede, University of Connecticut School of Medicine and Dentistry

Document Type

Article

Disciplines

Dentistry | Medicine and Health Sciences

Abstract

Background

In chronic kidney disease (CKD), inadequate nutritional intake, inflammation, and increased oxidative stress have been the major contributing factors in malnutrition pathogenesis. However, there is still a paucity of evidence assessing the magnitude of the effect of tooth loss on malnutrition in CKD populations. The authors hypothesize that among patients with CKD, tooth loss may affect nutritional status, using the National Health and Nutrition Examination Survey 1988 to 1994 (NHANES III).

Methods

Glomerular filtration rate (GFR) was estimated based on cystatin C levels using the relevant equation. Urinary albumin-to-creatinine ratio (albuminuria) was calculated in milligrams per gram with a cutoff point of 30 mg/g. CKD was defined based on estimated GFR <60 mL/minute/1.73m² and albuminuria ≥30 mg/g. The cutoff point for serum albumin was set at 3.7 g/dL. Tooth loss categories were based on the number of missing and replaced teeth.

Results

A total of 2,749 patients was included and stratified based on their oral health status. There was a statistically significant correlation between tooth loss and the proportion of patients with low protein and caloric intake (P = 0.02 and 0.01, respectively). Serum albumin reached a frequency peak in the fully edentulous group without dentures (group 4, 19.2%). In the same group, individuals had lower protein (30.1%) and caloric intake (30.2%) (P = 0.01 and 0.02, respectively). Furthermore, logistic regression analysis confirmed the significant role of tooth loss on serum albumin and protein and energy intake in this population even after adjusting for confounding variables.

Conclusion

Tooth loss independently predicts low energy and protein intake, as well as serum albumin levels, biomarkers of malnutrition in CKD.

Comments

J Periodontol. Author manuscript; available in PMC 2015 Jun 17. Published in final edited form as: J Periodontol. 2014 Jul; 85(7): 899–907. Published online 2013 Nov 11. doi: 10.1902/jop.2013.130347 PMCID: PMC4469954 NIHMSID: NIHMS695999

Recommended Citation

Ioannidou, Efthimia Effie and Swede, Helen, "Tooth Loss Strongly Associates With Malnutrition in Chronic Kidney Disease" (2014). UCHC Articles - Research. 273.
https://digitalcommons.lib.uconn.edu/uchcres_articles/273