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Periodontitis and renal function decline in type 2 diabetes: a prospective cohort study.

Risako Mikami1, Koji Mizutani2, Miho Ishimaru3

  • 1Department of Advanced Biomaterials, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Tokyo, Japan.

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|November 21, 2025
PubMed
Summary

Periodontitis, a gum disease, may worsen kidney function in type 2 diabetes patients. This effect appears independent of blood sugar control, highlighting a direct link between gum health and kidney health.

Keywords:
Causal mediation analysisDiabetes mellitus type 2Diabetic nephropathiesGlomerular filtration ratePeriodontitis

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Area of Science:

  • Nephrology
  • Periodontology
  • Endocrinology

Background:

  • Periodontitis is prevalent in patients with type 2 diabetes mellitus (T2D).
  • Renal function decline is a common complication in T2D.
  • The relationship between periodontitis and renal function in T2D requires further investigation.

Purpose of the Study:

  • To investigate the impact of periodontitis on renal function in T2D patients.
  • To explore potential mediating pathways, including glycemic control, in this association.

Main Methods:

  • A six-month prospective study of 73 T2D patients with poorly controlled diabetes.
  • Assessment of renal function (eGFR) and periodontal parameters at baseline.
  • Regression and causal mediation analyses to determine associations and pathways.

Main Results:

  • A significant decline in estimated glomerular filtration rate (eGFR) was observed (p < 0.001).
  • eGFR decline was associated with periodontitis severity and inflammatory surface area.
  • Glycemic control did not significantly mediate the relationship between periodontitis and eGFR decline.

Conclusions:

  • Periodontitis may directly contribute to renal function decline in T2D patients.
  • The detrimental effect of periodontitis on kidney function appears to be partly independent of glycemic control.