1 3 Int Urol Nephrol DOI 10.1007/s11255-017-1571-5 NEPHROLOGY – ORIGINAL PAPER The impact of periodontal disease on physical and psychological domains in long-term hemodialysis patients: a cross-sectional study Gabriel Veisa 1 · Alexandra Tasmoc 2,3 · Ionut Nistor 1 · Liviu Segall 1 · Dimitrie Siriopol 1 · Sorina Mihaela Solomon 4 · Mihaela Dora Donciu 1 · Luminita Voroneanu 1 · Andra Nastasa 1 · Adrian Covic 1 Received: 12 December 2016 / Accepted: 11 March 2017 © Springer Science+Business Media Dordrecht 2017 the mean value of GP was 4.0 ± 1.3, mean PI was 1.8 ± 0.9, and mean CI was 1.3 ± 0.7. Regarding the QoL, the means for PCS and MCS were 38.0 ± 17.3 and 45.0 ± 16.3, respec- tively. In univariate analysis, the physical and mental compo- nents of QoL were significantly associated with the gingival and periodontal index, the bacterial plaque index and the cal- culus index. In the multivariable linear regression, only the gingival and periodontal index remained significantly associ- ated with physical component (β = -3.26, p = 0.04, 95% CI -6.39 to -0.13) and mental component (β = -5.57, p = 0.001, 95% CI -8.74 to -2.41) of QoL. Conclusion Our study shows a high prevalence and sever- ity of periodontal disease. The gingival and periodontal index was associated with low QoL, both on physical and on mental components. Keywords End-stage kidney disease · Periodontal disease · Quality of life · Hemodialysis Introduction Poor oral health is a major public health problem, and despite improvements in prevention and treatment, severe periodontitis is found in 5–20% of most adult populations worldwide [1]. Periodontal disease (PoD) is a chronic infectious disease that results in the inflammation of specialized tissues sur- rounding and supporting the teeth. It can lead to a progres- sive loss of connective tissue attachment of alveolar bone. This tissue destruction is characterized by formation of per- iodontal pockets which act as reservoirs for bacterial colo- nization of the dentogingival environment [2, 3]. Chronic inflammation contributes to both coronary heart disease and chronic kidney disease progression [4]. Abstract Purpose Periodontal disease is a chronic infectious dis- ease. Individuals with end-stage kidney disease (ESKD) experience impaired quality of life (QoL) and low oral health. This is the first comprehensive study which aimed to explore the link between periodontal disease and quality of life, assessed with the Short Form 36-Item Health Sur- vey in hemodialysis patients. Methods In total, 101 patients (57 females) with ESKD were recruited from two Romanian dialysis centers. Peri- odontal disease assessment included the measurement of periodontal disease index, with its three components: the gingival and periodontal index (GP), the bacterial plaque index (PI) and the calculus index (CI). For assessing QoL, we used the Short Form 36-Item Health Survey (SF-36), with its two components: physical component (PCS) and mental component (MCS). Results The mean age was 52.5 ± 14.3 years. The dialysis vintage was 6.7 ± 5.6 years. According to periodontal status, Gabriel Veisa and Alexandra Tasmoc have contributed equally to this work. * Alexandra Tasmoc alexandra_tash@yahoo.com 1 Nephrology Department, Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, Iasi, Romania 2 Dialysis and Renal Transplantation Center, “Dr. C. I. Parhon” University Hospital, Iasi, Romania 3 Medical Deontology and Bioethics Department, Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, Iasi, Romania 4 Periodontology Department, Faculty of Dental Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, Iasi, Romania