BACKGROUND This systematic review aimed to investigate whether non-surgical periodontal therapy (NSPT) can reduce systemic inflammatory levels and improve metabolism in patients undergoing haemodialysis (HD) and/or peritoneal dialysis (PD). METHODS Electronic databases (PubMed, EMBASE, CENTRAL, CNKI, and WFPD) were searched for randomized controlled trials (RCTs) performed through July 2019. The risk of bias within studies was assessed with the Cochrane Collaboration's risk assessment tool. The systemic inflammatory and metabolic outcomes included the highly sensitive C-reactive protein (hs-CRP), interleukin 6 (IL-6), tumour necrosis factor-a (TNF-a), the albumin (Alb), and lipid metabolite levels. Meta-analyses (MAs) were performed to calculate the overall effect size where appropriate. RESULTS Five RCTs were included in this study. Compared with untreated periodontitis groups, the dialysis patients after NSPT significantly showed decreased hs-CRP levels at less than or equal to 2 months (standardized mean difference: - 1.53, 95% confidence interval - 2.95 to - 0.11). No significant difference was found in IL-6 and Alb levels following NSPT at either the 3- or 6- month follow-ups. No MAs could be performed on the TNF-a level and the lipid metabolic markers. CONCLUSIONS NSPT can moderately reduce serum hs-CRP levels in HD and/or PD patients, but did not significantly change IL-6 or Alb levels. For TNF-a and lipid metabolism markers, no sufficient evidence supports that these levels are changed after NSPT. Additional scientific research is necessary to assess the effects of NSPT on systemic inflammation and metabolic parameters in dialysis patients.

中文翻译：

---

非手术牙周治疗对接受血液透析和/或腹膜透析的患者全身炎症和代谢指标的影响：系统评价和荟萃分析。

背景技术本系统综述旨在研究非手术牙周治疗（NSPT）是否可以降低正在接受血液透析（HD）和/或腹膜透析（PD）的患者的全身炎症水平并改善其代谢。方法在电子数据库（PubMed，EMBASE，CENTRAL，CNKI和WFPD）中进行搜索，直至2019年7月进行的随机对照试验（RCT）。使用Cochrane Collaboration的风险评估工具评估了研究中出现偏倚的风险。全身炎症和代谢结果包括高度敏感的C反应蛋白（hs-CRP），白介素6（IL-6），肿瘤坏死因子-a（TNF-a），白蛋白（Alb）和脂质代谢物水平。进行荟萃分析（MA），以在适当的情况下计算总体效应大小。结果本研究包括5个RCT。与未治疗的牙周炎组相比，NSPT后的透析患者在少于或等于2个月时显着降低了hs-CRP水平（标准化平均差异：-1.53​​，95％置信区间-2.95至-0.11）。在3个月或6个月的随访中，NSPT后IL-6和Alb水平均无显着差异。无法在TNF-α水平和脂质代谢标志物上进行MA。结论NSPT可以适度降低HD和/或PD患者的血清hs-CRP水平，但不会显着改变IL-6或Alb水平。对于TNF-α和脂质代谢标志物，没有足够的证据支持NSPT后这些水平发生改变。为了评估NSPT对透析患者的全身炎症和代谢参数的影响，还需要进行其他科学研究。