Association between chronic azotemic kidney disease and the severity of periodontal disease in dogs

Naturally occurring periodontal disease affects > 75% of dogs and has been associated with cardiac lesions and presumptive endocarditis. However, the relationships between periodontal disease and chronic kidney disease (CKD) in dogs have not been studied. In a retrospective longitudinal study the incidence of azotemic CKD was compared between a cohort of 164,706 dogs with periodontal disease and a cohort of age-matched dogs with no periodontal disease from a national primary care practice. These dogs contributed 415,971 dog-years of follow-up from 2002 to 2008. Hazard ratios and 95% confidence intervals from Cox regression were used to compare the incidence of azotemic CKD in dogs with stage 1, 2, or 3/4 periodontal disease to dogs with no periodontal disease. The hazard ratio for azotemic CIO increased with increasing severity of periodontal disease (stage 1 hazard ratio = 1.8,95% confidence interval: 1.6.2.1; stage 2 hazard ratio = 2.0,95% confidence interval: 1.7, 2.3; stage 3/4 hazard ratio = 2.7, 95% confidence interval: 2.3, 3.0; P-trend = < 0.0001) after adjustment for age, gender, neuter status, breed, body weight, number of hospital visits, and dental procedures. Increasing severity of periodontal disease was also associated with serum creatinine > 1.4 mg/di and blood urea nitrogen > 36 mg/di, independent of a veterinarian's clinical diagnosis of CKD. (C) 2011 Elsevier B.V. All rights reserved.