Periodontal Disease and Incident CKD in US Hispanics/Latinos: The Hispanic Community Health Study/Study of Latinos

Rationale & Objective: Recent studies suggest that periodontal disease may be associated with incident chronic kidney disease (CKD). However, studies have focused on older populations, and US Hispanics/Latinos were not well represented.Study Design: Observational cohort.Setting & Participants: We analyzed data from the Hispanic Community Health Study/Study of Latinos who completed a baseline visit with a periodontal examination and a follow-up visit, and did not have CKD at baseline.Predictors: Predictors included >= 30% of sites with clinical attachment loss >= 3 mm, >= 30% of sites with probing depth >= 4 mm, percentage of sites with bleeding on probing, and absence of functional dentition (<21 permanent teeth present).Outcomes: Outcomes were incident low estimated glomerular filtration rate (eGFR) (eGFR <60 mL/min/1.73 m(2) and decline in eGFR >= 1 mL/min/year); incident albuminuria (urine albumin:creatinine ratio [ACR] >= 30 mg/g); and change in eGFR and ACR.Analytic Approach: Poisson and linear regression.Results: For the sample (n = 7.732), baseline mean age was 41.5 years, 45.2% were male, 11.7% had >= 30% of sites with clinical attachment loss >= 3 mm, 5.1% had >= 30% of sites with probing depth >= 4 mm, 30.7% had >= 50% of sites with bleeding on probing, and 16.2% had absent functional dentition. During a median follow-up of 5.9 years, 149 patients developed low eGFR and 415 patients developed albuminuria. On multivariable analysis, presence versus absence of >= 30% of sites with probing depth >= 4 mm and absence of functional dentition were each associated with increased risk for incident low eGFR (incident density ratio, 2.31; 95% CI, 1.14-4.65 and 1.65, 95% CI, 1.01-2.70, respectively). None of the other predictors were associated with outcomes.Limitations: Only a single kidney function follow-up measure.Conclusions: In this cohort of US Hispanics/Latinos, we found that select measures of periodontal disease were associated with incident low eGFR. Future work is needed to assess whether the treatment of periodontal disease may prevent CKD.