치주질환과 만성신장질환의 연관성: 코호트 연구에 대한 체계적 고찰 = Relationship between Periodontal Disease and Chronic Kidney Disease: A Systematic Review of Cohort Studies

국문 초록 (Abstract)

본 연구는 치주질환과 신장질환의 연관성을 알아보기 위한 체계적 고찰이다. Embase, PubMed, The Cochrane Library데이터베이스에서 2016년 4월 17일 검색을 완료하였다. 문헌의 선택은 코호트 연구 설계를 기준으로 하였으며, 환자군은 치주질환 또는 중증의 치주질환이 있는 대상자로 하였다. 최종 결과는 만성신장질환의 발생이나 신장기능의 저하로 eGFR을 제시한 연구로 하였다. 최종 선정된 문헌의 양적합성을 위하여 Review Manager (RevMan) 통계 분석 소프트웨어를 이용하였다. 고정효과모형 멘텔-헨젤 방법(M-H)을 이용하여 메타분석을 시행하여 치주질환과 만성신장질환의 연관성을 추정하였다. 검색 전략을 이용하여 총 3,018개의 문헌이 검색되었고, 그 중 4개의 문헌이 최종 분석에 포함되어 메타 분석한 결과 치주질환이 만성신장질환 발생위험과 유의한 연관성이 있음이 나타났다(OR, 1.65; 95%CI, 1.44∼1.90; p＜0.001). 만성신장질환 발생 및 신장기능저하를 예방하기 위해서는 개인의 삶의 질 저하와 의료비용부담을 줄이기 위해 기존에 알려진 전통적 위험인자 외에 만성신장질환에 영향을 미치는 치주질환의 예방 및 관리의 필요성이 크다.

다국어 초록 (Multilingual Abstract)

The purpose of this systematic review was to investigate the association between periodontal disease and chronic kidney disease. A search of Embase, PubMed and The Cochrane Library databases was performed up to April 17, 2016. Article selection was based on cohort study design and the study subjects were patients with periodontal disease or severe periodontal disease. The final result was development of chronic kidney disease and kidney function decrease based on the estimated glomerular filtration rate values. The quantitative synthesis of the final selected articles was assessed using Review Manager statistical analysis software. A fixed-effects model meta-analysis was performed to estimate the degree of association between periodontal disease and chronic kidney disease. The search strategy identified 3,018 potentially eligible articles, of these, four studies were finally selected for meta-analysis, revealing that periodontal disease was significantly associated with the risk of developing chronic kidney disease (odds ratio, 1.65; 95% confidence interval, 1.44∼1.90; p＜0.001). In order to prevent the development of chronic kidney disease and kidney function decrease it is important to prevent periodontal disease, as well as minimizing the traditional risk factors known to reduce the quality of life of patients and increase disease burden.

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