Abstract
BACKGROUND: To assess the association between periodontal disease (PD) and the prognosis of chronic kidney disease (CKD). METHODS: A systematic literature search was conducted using PubMed, Embase, and Cochrane Library to identify eligible cohort studies until April 2023. Relative risk (RR) with a 95% CI was used to evaluate the strength of the relationship between PD and CKD prognosis using the random-effects model. RESULTS: Ten cohort studies involving 10 144 patients with CKD were selected for the meta-analysis. The summary results indicated that PD was associated with an increased risk of all-cause mortality in patients with CKD (RR: 1.32; 95% CI, 1.10-1.59; p = 0.003). Although no association was observed between PD and the risk of cardiac death in patients with CKD ( p = 0.180), while sensitivity analysis revealed PD may be associated with the risk of cardiac death (RR: 1.31; 95% CI, 1.05-1.64; p = 0.017). In addition, subgroup analyses revealed that the strength of the association of PD with the risks of all-cause mortality and cardiac death varies when stratified by region, sex, and CKD stage. CONCLUSION: PD might exert a harmful effect on the risk of all-cause mortality, with a potential but unconfirmed association with cardiac death in patients with CKD.