A cohort of African American participants enrolled in the Dental-Atherosclerosis Risk in Communities study (D-ARIC), were subsequently enrolled in the Jackson Heart Study (JHS). The D-ARIC study, which was conducted between 1996 and 1998, involved a subgroup of the ARIC study cohort visit 4.The ARIC study was a longitudinal study of 15,792 individuals aged 45-64 years recruited from 4 U.S. suburban communities with a primary purpose of investigating the etiology and natural history of atherosclerosis, including the determination of risk factors. Participants underwent an oral examination by dental hygienists. The clinical measures examined were bleeding on probing, probing depth, and gingival recession. The JHS is a community-based cohort study with the primary focus of examining risk factors for cardiovascular disease among African Americans. The study was conducted between 2000 and 2004. All participants were living in the tri-county area of Jackson, Mississippi. The final cohort of individuals enrolled in both the D-ARIC and JHS studies was comprised of 669 individuals. There were 240 males, 459 females, and the average age was 65.
The main outcome measure was incident CKD at follow-up (i.e., the first JHS visit), which was defined as estimated glomerular filtration rate (eGFR) <60 ml/minute/1.73m2
with >5% annualized kidney function loss. The eGFR was calculated using calibrated serum creatinine. The Chronic Kidney Disease Epidemiology Collaboration equation was used. The primary predictor was periodontal disease, which was determined using the Centers for Disease Control and Prevention/American Academy of Periodontology (CDC/AAP) 2003 consensus definition. According to this, severe periodontal disease was defined as the presence of ≥2 interproximal sites with clinical attachment loss (CAL) ≥6 mm (not on the same tooth) and ≥1 interproximal sites with probing depth (PD) ≥5 mm. Moderate periodontal disease was defined as ≥2 interproximal sites with CAL ≥4 mm (not on the same tooth) or ≥2 interproximal sites with PD ≥5 mm, also not on the same tooth. Mild periodontal disease was defined as ≥2 interproximal sites with CAL ≥3 mm and ≥2 interproximal sites with PD ≥4 mm (not on the same tooth) or 1 site with PD ≥5 mm. As a secondary predictor, the authors also measured the presence of a periodontal inflamed surface area. The ultimate goal of the authors was to examine the association of periodontal disease with worsening kidney function.
This indicator is based on analysis in published literature: Grubbs V, Vittinghoff E, Beck JD, et al. Association between periodontal disease and kidney function decline in African Americans: The Jackson Heart Study. J Periodontol