Prevalence and Systemic Factors Associated with Periodontitis among Kidney Transplant Recipients: A Cross-sectional...

Kidney transplant recipients (KTRs) are particularly vulnerable to periodontal disease due to long-term immunosuppression, metabolic disturbances, and chronic inflammation. However, data in Southeast Asia remain scarce. The aim of the study was to determine the prevalence, stage distribution of periodontitis, and to examine systemic and behavioral factors associated with the disease among Vietnamese KTRs; as a secondary exploratory aim, we evaluated selected systemic biomarkers (C-reactive protein [CRP], serum urea, and platelet count [PLT]) and descriptively summarized their cross-sectional discrimination with respect to the periodontitis status using prespecified receiver operating characteristic (ROC) analyses. A cross-sectional analytical study among 300 KTRs at 103 Military Hospital, Vietnam Military University, Hanoi, Vietnam.

A cross-sectional study was conducted among 300 KTRs at a teaching hospital in Hanoi, Vietnam, from June 2025 to October 2025. Periodontitis was defined and staged according to the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions (American Academy of Periodontology/European Federation of Periodontology). Descriptive statistics, chi-square/Fisher's exact test, and logistic regression were used to examine associations. Crude and adjusted odds ratios (ORs and aORs) were calculated. An exploratory ROC analysis was performed to assess the discriminatory ability of selected clinical and biochemical variables. Chi-square, t test, analysis of variance, multivariate logistic regression, and ROC analysis using Statistical Package for the Social Sciences version 27.0 were used for statistical analyses.

Periodontitis was present in 77.7% of participants. Stage I disease was most prevalent (33.0%), followed by Stage II (27.0%) and Stage III (16.3%); only 1.3% of patients had Stage IV disease. In multivariable analysis, poor oral hygiene (OHI-S; aOR = 3.47), lower PLTs (aOR = 0.986), higher CRP levels (CRP; aOR = 1.32), and elevated serum urea (aOR = 2.09) were independently associated with periodontitis.

Periodontitis is highly prevalent in Vietnamese KTRs, predominantly in moderate stages, underscoring the need for preventive strategies. Systemic inflammation, renal biomarkers, and poor oral hygiene were strongly associated with disease. Integrating periodontal assessment into routine post-transplant care may support preventive oral health strategies in this population.