Periodontal disease was more prevalent in those with CKD than in those without CKD (9.2% vs. 4.8%; p< 0.001).
Chart Explanation: Periodontal disease has been implicated as a novel risk factor for CKD. In 1988-1994, the prevalence of periodontal disease in U.S. adults was 7.6%. Periodontal disease was significantly more prevalent in those with CKD than in those without CKD (9.2% vs. 4.8%; p< 0.001). The median follow-up time was 14 years. The overall prevalence of CKD in the examined population was 12.4%.
The National Health and Nutrition Examination Survey III (NHANES III) is an earlier version of today’s continuous NHANES; this third iteration of the National Health Examination Survey was conducted from 1988-1994. NHANES III focused on oversampling many groups within the U.S. population aged 2 months or older. These oversampled groups included children aged 2 months to 5 years, persons 60 years or older, Mexican-Americans, and non-Hispanic blacks. This survey also concentrated on health and nutrition but additionally began to collect environmental exposure and infectious disease data.
This indicator is based upon analysis in published literature: Ricardo AC, Athavale A, Chen J, et al. Periodontal disease, chronic kidney disease and mortality: results from the third National Health and Nutrition Examination Survey. BMC Nephrol
|Description of Measure||Prevalence of Periodontal Disease |
|Type of Data Source||Public|
|Data Set||NHANES III|
|Health Care System Data||No|
|Regional or National?||National|
|Demographic Group||Noninstitutionalized U.S. residents aged 18 years or older|
|Numerator||NHANES III adults (18 years or older) men and non-pregnant women with periodontal disease who completed a periodontal assessment|
|Denominator||NHANES III adults (18 years or older) men and non-pregnant women without CKD who completed a periodontal assessment|
|Definition of CKD||Estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2, using the CKD epidemiology collaboration (CKD-EPI) equation for creatinine or the presence of urine albumin-tocreatinine ratio (ACR) ≥ 30 mg/g|
|Primary Data Source Indicator||Prevalence of periodontal disease|
|Primary Indicator Method of Measurement||Periodontal disease was defined based on the Centers for Disease Control and Prevention (CDC) criteria as follows: moderate periodontal disease as at least 2 mesial sites with > 4 mm attachment loss or at least 2 mesial sites with 5 mm pocket depth (not on the same tooth), and severe periodontal disease as at least 2 mesial sites with > 6 mm attachment loss and one or more mesial sites with > 5 mm pocket depth. For the purposes of this study, individuals with either moderate or severe disease were classified as having periodontal disease.|
|Secondary Data Source Indicator||Presence of CKD|
|Secondary Indicator Method of Measurement||Measuring the estimated glomerular filtration rate (eGFR) or measuring the presence of urine albumin-to-creatinine|
|Frequency of Measurement (Primary)||Once (at baseline)|
|U.S. Region Covered by Primary Variable||All|
|Additional Data Items of Interest||Stage of CKD, other stratification variables of interest (race/ethnicity, educational attainment, smoking by self-report, diabetes, BMI, hypertension, CVD by self-report)|
|Limitations of Indicator||Possible misclassification of CKD (CKD was defined in study by single measurement of eGFR and albuminuria); periodontal disease status determined by assessment of only half of the mouth; definition of periodontal disease used might underestimate prevalence; periodontal disease development during follow-up was not taken into consideration|
Appropriate NHANES survey weights must be used for all analyses; creatinine measurements must be calibrated for NHANES III
References and Sources:
Ricardo AC, Athavale A, Chen J, et al. Periodontal disease, chronic kidney disease and mortality: results from the third National Health and Nutrition Examination Survey. BMC Nephrol. 2015;16:97.