About this trial
The goal of this observational study is to investigate the relationship between chronic kidney disease (CKD) and periodontitis, and to evaluate the potential mediating role of dietary inflammatory potential, measured by the Dietary Inflammatory Index (DII), in this association.
The main question it aims to answer is:
Does a pro-inflammatory diet, as reflected by a higher DII score, exacerbate periodontal inflammation in individuals with chronic kidney disease?
Participants will include adults diagnosed with CKD at various stages. Periodontal status will be assessed through clinical parameters such as probing depth, clinical attachment loss, and bleeding on probing. Dietary intake will be evaluated using a validated food frequency questionnaire, and DII scores will be calculated accordingly. The study will aim to observe and analyze whether dietary inflammation contributes to increased periodontal disease severity in CKD patients, potentially offering insight into modifiable risk factors relevant to both systemic and oral health.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Being between 18 and 65 years of age
Being diagnosed with Chronic Kidney Disease (having an eGFR below 60 ml/min/1.73 m² for at least 3 months or a urine albumin-to-creatinine ratio above 30 mg/g (proteinuria))
Having at least 20 teeth
Not having received periodontal therapy in the last 6 months
Disqualifiers
Patients with an active infectious disease,
Those taking medications that could affect periodontal tissues,
History of endocarditis,
Recent antibiotic use (within 4 months),
Trial population
Patients diagnosed with chronic kidney disease who come to the Periodontology Clinic of Recep Tayyip Erdoğan University Faculty of Dentistry for routine periodontal treatment
Trial design
Case-only
Cross-sectional
Treatments tested in this trial
Not listed
Trial groups
Trial outcomes
Primary outcomes
Dietary Inflammatory Index
The Dietary Inflammatory Index (DII) provides a score that measures the potential for a person's diet to cause inflammation in the body. This index is based on the pro- or anti-inflammatory effects of consumed foods and nutrients. Participants' 3-day food intake records will be entered into the system, and average daily energy intake, macronutrients, and micronutrients will be calculated. Based on the food records, average daily intake of 36 nutrients will be determined, and DII scores will be derived from these nutrient parameters. A lower score indicates a more antiinflammatory diet, while a higher score indicates a more proinflammatory diet.
Secondary outcomes
Clinical Periodontal Parameters (Plaque Index)
Plaque Index (PI) (Silness and Löe, 1964) This index is used to evaluate the amount of dental plaque accumulation on tooth surfaces. Each tooth's four surfaces (buccal, lingual, mesial, distal) are examined using a probe or visually. Each surface is scored from 0 to 3. The average score is calculated for each tooth. The overall plaque index is obtained by averaging the scores from all examined teeth. Score Description 0 No plaque. 1. No visible plaque, but a slight film of plaque is detected when a probe is run along the gingival margin. 2. Visible plaque along the gingival margin, forming a continuous band. 3. Abundant plaque covering the gingival area and extending toward the middle of the tooth surface, including the interproximal spaces.
Clinical Periodontal Parameters (Gingival Index)
The Gingival Index is used to assess the presence and severity of gingival inflammation (gingivitis). Four surfaces of each tooth (buccal, lingual, mesial, distal) are examined visually and with a periodontal probe. The evaluation considers color changes, edema (swelling), tissue consistency, and bleeding on probing. Each surface is scored from 0 to 3. The average score per tooth is calculated, and then the overall average is used to determine the individual's GI score. Score Description 0 Healthy gingiva: normal color and texture, no bleeding 1. Mild inflammation: slight color change and swelling, no bleeding on probing 2. Moderate inflammation: redness, edema, soft tissue, bleeding on probing 3. Severe inflammation: marked redness and swelling, ulceration, possible spontaneous bleeding
Periodontal Clinical Parametres (Bleeding on Probing Index)
This index is used to assess the presence and severity of gingival inflammation by observing bleeding after gentle pressure is applied to the gingival sulcus using a periodontal probe. A thin periodontal probe is gently inserted into the gingival sulcus with light pressure (approximately 20-25 grams). Bleeding occurring within 10-30 seconds is observed. Each measurement site is recorded as either "bleeding present" or "bleeding absent." Presence of bleeding is an early and sensitive indicator of gingival inflammation. Score Description: 0 No bleeding 1 Bleeding present (mild or severe)
Periodontal Clinical Parametres (Probing Pocket Depth)
Using a Williams periodontal probe, the distance between the gingival margin and the base of the periodontal pocket is measured in millimeters at six sites per tooth: mesiobuccal, midbuccal, distobuccal, mesiolingual, midlingual, and distolingual. All teeth are measured. The values obtained from each site are summed and then divided by the total number of sites measured. This gives the average probing depth for the individual. Measurement Interpretation 1-3 mm Healthy sulcus 4-5 mm Shallow to moderate pocket ≥6 mm Deep periodontal pocket (advanced disease)
Other outcomes
Creatinine
Creatinine is a waste product generated from muscle metabolism and excreted by the kidneys; its serum level is used to assess renal function.
Albumin
Albumin is the main serum protein synthesized by the liver that maintains plasma oncotic pressure; it provides information about nutritional status and kidney function.
Blood urea nitrogen
Blood urea nitrogen (BUN) represents the amount of nitrogen in the blood derived from urea, a byproduct of protein metabolism, and is an indicator of renal function.
Glomerular filtration rate
Glomerular filtration rate (GFR) indicates the volume of blood filtered by the kidneys per minute and is a key parameter for evaluating renal function.
Sponsors and contacts
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