Efectos de la terapia periodontal quirúrgica y no quirúrgica sobre la función renal, los biomarcadores inflamatorios y la mortalidad en pacientes con enfermedad renal crónica: una revisión en paraguas
DOI:
https://doi.org/10.15517/q9ehq621Palabras clave:
Biomarcadores; Insuficiencia renal; Periodontitis; Revisión sistemática; Enfermedades periodontales; Revisión en paraguas.Resumen
La periodontitis y la enfermedad renal crónica (ERC) comparten mecanismos fisiopatológicos comunes, siendo la periodontitis una comorbilidad inflamatoria crónica que exacerba la inflamación sistémica en pacientes con ERC. Este estudio tuvo como objetivo analizar el efecto de la terapia periodontal quirúrgica y no quirúrgica sobre la función renal, los biomarcadores inflamatorios y la mortalidad en pacientes con ERC según la evidencia disponible. Se realizó una revisión en paraguas que incluyó revisiones sistemáticas y metaanálisis provenientes de bases de datos como PubMed, Clinical Key, Scopus, Cochrane, Scielo y Google Scholar. La calidad metodológica se evaluó mediante AMSTAR-2 y la calidad del reporte con PRISMA. Se analizaron cinco revisiones sistemáticas y metaanálisis que abarcaron 21 estudios primarios. La evidencia indica que la terapia periodontal reduce significativamente los biomarcadores inflamatorios sistémicos, como la interleucina-6 (IL-6) y la proteína C reactiva, además de mejorar los marcadores de función renal, incluyendo un aumento en la tasa de filtración glomerular. La terapia periodontal no quirúrgica se asoció con una reducción estadísticamente significativa de la mortalidad y la morbilidad cardiovascular, especialmente cuando se aplicó de forma intensiva y con seguimiento. Estos hallazgos sugieren que el tratamiento periodontal podría beneficiar la salud renal al disminuir la inflamación sistémica y reducir el riesgo de mortalidad relacionada con complicaciones cardiovasculares. Sin embargo, la heterogeneidad de los diseños de estudio y de las variables analizadas limita la posibilidad de establecer conclusiones definitivas. Se requiere investigación futura de alta calidad para clarificar estas asociaciones.
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Derechos de autor 2026 nny Marcela Vivares-Builes, María Teresa Pertúz-Rondón, German Márquez-Toro, Carlos Pizarro-Herrera, Andrés Alonso Agudelo-Suarez, Carlos M. Ardila.
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