Association of Apical Periodontitis With Chronic Kidney Disease

Study Overview
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Brief Summary
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This investigation is aimed to assess the prevalence and severity of apical periodontitis (AP) in different stages of CKD patients and its impact on the systemic (nutritional and inflammatory) markers was compared to healthy individuals.

Detailed Description
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105 CKD patients (35 early (EG), 35pre-dialysis (PDG) and 35 hemodialysis (HDG)groups and 105 age and gender matched healthy controls were assessed for prevalence and severity of apical periodontitis and oral disease burden . Inflammatory (hsCRP and ferritin) and nutritional (urea and creatinine) markers were estimated and eGFR was calculated for the study population. Logistic regression was used to determine the possible association between CKD and AP in study population and Linear regression was performed to evaluate the possible association between systemic markers and endodontic burden (EB) in experimental group.

Official Title
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Prevalence of of Apical Periodontal in Patients Chronic Kidney Disease & Its Association With Markers of Kidney Disease.

Conditions
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Chronic Kidney Diseases, Periapical Lesions

Intervention / Treatment
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* Biological: levels of CKD markers, Oral health status, apical periodontitis
* Biological: systemic inflammatory marker, Oral health status, apical periodontitis


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Known patient of CKD Stages 1,2,3,4 & 5 with estimated glomerular filtration rate [eGFR; MDRD] with mature permanent teeth. > 18 years > 8 natural teeth. Complete medical & dental history including panoramic radiographs of maxilla & mandible Exclusion Criteria: Patients having systemic disorders other than CKD (eg HIV, Diabetes mellitus, Coronary heart disease, history of secondary hyperparathyroidism). Pregnancy, lactation & contraceptives. Systemic conditions that contra indicates dental treatment. Use of antibiotics & anti-inflammatory in last 3 months Need for antibiotic prophylaxis. Hepatitis C and B virus. Patients on steroids.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Group-A CKD patients<br>Prevalence of apical periodontitis will be checked and non-surgical root canal treatment will be given to the patients with apical periodontitis and change in PAI score, eGFR & Systemic markers will be checked | Biological: levels of CKD markers, Oral health status, apical periodontitis<br>* To observe levels of CKD markers :Levels of serum keratinise ,urea, eGFR, and assessment of Oral health status, apical periodontitis<br>|
| Group-B Healthy individuals<br>Prevalence of apical periodontitis will be checked and non-surgical root canal treatment will be given to the patients with apical periodontitis and change in PAI score, eGFR & Systemic markers will be checked | Biological: systemic inflammatory marker, Oral health status, apical periodontitis<br>* estimation of hs-CRP levels, and assessment of Oral health status, apical periodontitis<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Periapical Index(PAI) | Periodical status will be assessed in periodical radiograph and scoring of periapical index will be done according to size and periphery of peri-apical radiolucency with coding 1 to 5 | 1 year | 
| eGFR | BY BLOOD SAMPLE measured in mL/min/1.73m2 | 1 year | 
| serum creatinine | BY BLOOD SAMPLE measured in mg/dL | 1 year | 
| hs-CRP | HIGH SENSITIVE C-reactive protein measured by ELISA kit in mg/L | 1 year | 
| Blood urea | measured by collecting blood sample in mg/dL | 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Apical Periodontitis, Root Canal Treatment