This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.Periodontal diseases are chronic gram-negative oral infections initiated in the gingiva and leading to alveolar bone destruction and gradual loss of tooth supporting connective tissues. Cumulatively, these infections affect more than 70% of the general population. Recent evidence indicates that chronic severe periodontal disease is associated with systemically elevated inflammatory mediators. Chronic kidney disease (CKD) patients are also characterized by a chronic inflammatory state which contributes to an extremely high rate of atherosclerotic complications. Recently, both serum interleukin-6 (IL-6) and C-reactive protein (CRP) levels have been found to predict cardiovascular mortality in CKD patients on HD. We hypothesize that periodontal infections are highly prevalent in the CKD population and that both periodontal infections and depressive symptoms affect the systemic inflammatory status of HD and pre-dialysis CKD patients.
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