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Periodontal Pocket Depth, Hyperglycemia, and Progression of Chronic Kidney Disease: A Population-Based Longitudinal Study  Jia-Feng Chang, MD, Jih-Chen.

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Presentation on theme: "Periodontal Pocket Depth, Hyperglycemia, and Progression of Chronic Kidney Disease: A Population-Based Longitudinal Study  Jia-Feng Chang, MD, Jih-Chen."— Presentation transcript:

1 Periodontal Pocket Depth, Hyperglycemia, and Progression of Chronic Kidney Disease: A Population-Based Longitudinal Study  Jia-Feng Chang, MD, Jih-Chen Yeh, DDS, Ya-Lin Chiu, DDS, Jian-Chiun Liou, PhD, Jing-Ru Hsiung, DDS, Tao-Hsin Tung, PhD  The American Journal of Medicine  Volume 130, Issue 1, Pages e1 (January 2017) DOI: /j.amjmed Copyright © 2016 Elsevier Inc. Terms and Conditions

2 Figure 1 (A) Unadjusted, partially, and fully adjusted hazard ratios (HR) of progression of chronic kidney disease across different categories of periodontal pocket depth in 1486 patients with periodontal diseases and chronic kidney disease during 7621 person-years of follow-up. (Partially adjusted: age, diabetes mellitus, periodontal pocket depth, albumin-to-creatinine ratio. Fully adjusted: age, diabetes mellitus, periodontal pocket depth, albumin-to-creatinine ratio, sex, hypertension, creatinine, smoking, and betel nut chewing.) The lowest hazard ratio group (periodontal pocket depth <3.8 mm) served as the reference group. Patients with higher periodontal pocket depth (>4.5 mm) had the greatest risk of progression of chronic kidney disease after full adjustments. Note that a linearly incremental risk of progression of chronic kidney disease associated with levels of periodontal pocket depth was robust. (B) Kaplan-Meier survival curves of event-free probability among patients with different categories of periodontal pocket depth. CI = confidence interval; PPD = periodontal pocket depth. The American Journal of Medicine  , e1DOI: ( /j.amjmed ) Copyright © 2016 Elsevier Inc. Terms and Conditions

3 Figure 2 (A) Unadjusted, partially, and fully adjusted hazard ratios (HR) of progression of chronic kidney disease across different categories of hemoglobin A1c (HbA1C) in 1486 patients with periodontal diseases and chronic kidney disease during 7621 person-years of follow-up. (Partially adjusted: age, diabetes mellitus, periodontal pocket depth, albumin-to-creatinine ratio. Fully adjusted: age, diabetes mellitus, periodontal pocket depth, albumin-to-creatinine ratio, sex, hypertension, creatinine, smoking, and betel nut chewing.) The lowest hazard ratio group (HbA1C <6.0%) served as the reference group. Patients with higher HbA1C (>6.5%) had the greatest risk of progression of chronic kidney disease after full adjustments. Note that a linearly incremental risk of progression of chronic kidney disease associated with HbA1C levels was robust. (B) Kaplan-Meier survival curves of event-free probability among patients with different categories of HbA1C. CI = confidence interval. The American Journal of Medicine  , e1DOI: ( /j.amjmed ) Copyright © 2016 Elsevier Inc. Terms and Conditions

4 Figure 3 (A) The hazard ratios (HR) of progression of chronic kidney disease (CKD) across different categories of periodontal pocket depth and hemoglobin A1c (HbA1C) in 1486 patients with periodontal diseases and chronic kidney disease during 7621 person-years of follow-up (fully adjusted: age, diabetes mellitus, periodontal pocket depth, albumin-to-creatinine ratio, sex, hypertension, creatinine, smoking, and betel nut chewing). The reference group (periodontal pocket depth [PPD] <3.8 mm and HbA1C <6.0%) had the lowest HR. Patients with higher periodontal pocket depth (>4.5 mm) and higher HbA1C (>6.5%) had the greatest risk of progression of chronic kidney disease after full adjustments. (B) Kaplan-Meier survival curves of event-free probability among patients with different categories of periodontal pocket depth and HbA1C. The American Journal of Medicine  , e1DOI: ( /j.amjmed ) Copyright © 2016 Elsevier Inc. Terms and Conditions

5 Supplementary Figure (A) Comparison of structures of periodontal tissues in health and disease. (B) Measurement of periodontal pocket depth using a periodontal probe. (C) Illustration of measurement method and pathologic landmarks of periodontal diseases. A = alveolar bone; BP = bottom of the periodontal pocket; C = calculus; CAL = clinical attachment loss; CEJ = cemento-enamel junction; D = destructive alveolar bone; E = epithelium; G = gingival sulcus; GR = gingival recession; H = healthy gingiva; I = inflammatory gingiva; P = periodontal pocket; PPD = periodontal pocket depth; PD = periodontal disease; R = root. The American Journal of Medicine  , e1DOI: ( /j.amjmed ) Copyright © 2016 Elsevier Inc. Terms and Conditions


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