Diagnostics last 10 slides Flashcards
CKD
Chronic kidney disease (CKD) is defined as reduced kidney function.
* This has to be that present for three or more months.
How is CDK determined
using the estimated glomerular filtration rate (GFR)
CDK is characterised by?
progressive destruction of renal parenchyma and loss of functional nephrons
Which conditions influence CDK
diabetes, high BP
How Could Periodontitis Affect the Kidneys?
Sometimes oral bacteria enter the blood temporarily (this is called transient bacteraemia).
Normally, your immune system clears this quickly, with no long-term effects.
Under certain conditions (like weakened immunity or existing disease), bacteria in the blood can:
Survive longer,
Settle in distant body parts, and
Cause infection or inflammation elsewhere (e.g. heart, kidneys, brain).
This means oral bacteria move from their original site (the mouth) to other organs.
This is one mechanism linking oral diseases to systemic diseases like:
Alzheimer’s,
Chronic kidney disease,
Main causes of systemic disease
Dysbiosis: An imbalance in the oral microbiome (the mix of good and harmful bacteria).
Metastatic infection: Bacteria escape the mouth and enter the bloodstream, potentially spreading elsewhere
What are some biomearkers for CKD
creatinine, elevated blood urea nitrogen levels and urine analysis
Serum creatinine
Creatinine is a waste product in your blood that comes from your
muscles.
* Healthy kidneys filter creatinine out of your blood through your urine.
* Your serum creatinine level is based on a blood test that measures
the amount of creatinine in your blood.
* It tells how well your kidneys are working.
* When your kidneys are not working well, your serum creatinine level
goes up.
GFR estimations are based on endogenous serum biomarkers such as
creatinine and crystatin C
Crystatin C
Cystatin C is a protein that is produced by the cells in your body.
* When kidneys are working well, they keep the level of cystatin C in
your blood just right.
* If the level of cystatin C in your blood is too high, it may mean that
your kidneys are not working well.
Problems with use of creatinin for CKD
Age Variations
As people age, muscle mass naturally decreases.
Less muscle = less creatinine produced.
So, an older person with reduced kidney function might still have a “normal” creatinine level, making it hard to spot CKD early.
⚖️ 2. Sudden Weight Changes
Gaining or losing weight (especially muscle) changes how much creatinine is produced.
This makes it harder to interpret whether kidney function is actually declining or if the change is just due to body composition.
🧪 3. Lack of Standardization of Testing Kits
Different labs might use different methods or tools to measure creatinine.
This leads to inconsistent results between facilities, reducing accuracy and reliability.
Which polyamine is most relevant in CKD research?
Putrescine
What does putrescine break down into?
spermidine and spermin
How are polyamines linked to CKD?
Since the 1970s, they have been associated with kidney disease progression and are now being studied as biomarkers for CKD.
What change is seen in polyamines in CKD patients?
Elevated levels of putrescine are observed, particularly in patients with chronic renal failure.
How might putrescine contribute to anaemia in CKD?
It may reduce the proliferation and maturation of blood-forming cells, contributing to anaemia in end-stage renal disease.
Current methods for detecting Periodontal disease and limitations
Bleeding on probing
pocket depth analysis
clinical attachment level (measures how much bone and gum tissue has been lost)
Amount of plaque seen
Radiograpghs to see alveolar bone loss.
Do not provide real-time information on active state of disease
Which complex is Porphyromonas gingivalis
Of the red complex microorganisms, P. gingivalis, has been
considered as the most influential due to its innate ability to
avoid the host immune response.
Structure of porphyromonas gingivalis
gram -, non-motile, obligatory anaerobic coccobacilli
How does p. gingivalis cause disease
P. gingivalis rapidly adheres to the host cell surfaces.
* This is followed by the internalisation of the bacterium by cells.
* Produces a range of metabolites which mediate host cell damage
and prolong infection (cadaverine)
