U.S. flag

An official website of the Department of Health & Human Services

AHRQ: Agency for Healthcare Research and Quality
Powered by the Evidence-based Practice Centers
✓ Evidence Reports ✓ All of EHC
✓ Evidence Reports ✓ All of EHC

SHARE:

FacebookTwitterFacebookPrintShare

Linking Dental Services to Treatment Outcomes for Chronic Kidney Disease: A Rapid Response Review

Rapid Evidence Product Nov 1, 2024
Download the file for this report here.

Page Contents

In the past several years, there has been increasing appreciation for the interconnectedness of oral health and whole body wellness, highlighted by the US Surgeon General’s report in 2000.1 Many subsequent efforts have established a connection between oral diseases and impacts on a variety of systemic diseases.2 The goal of this report is to review evidence on the efficacy of dental care/treatment in improving outcomes for patients with chronic kidney disease.

Chronic kidney disease (CKD) impacts a significant portion of the United States population, with approximately 35.5 million people affected, comprising ~14% of American adults,3 and 850 million globally.4 CKD is multifactorial, with diabetes being the most common cause of kidney failure in the United States. Other causes of CKD include hypertension, heart disease, primary glomerular diseases, genetic diseases and risk factors, and systemic inflammatory diseases.5 Often, multiple conditions in the setting of aging combine to predispose to CKD. Additionally, CKD is increasing in prevalence faster than diabetes, cardiovascular disease, stroke and cancer and is set to become the fifth leading cause of death worldwide.4

CKD is a condition in which kidney function is impaired, leading to a buildup of excess fluid and toxic waste, which in turn causes other health complications such as high blood pressure, heart disease, and stroke. Kidney function and kidney damage are assessed by a number of biomarkers; serum creatinine and other serum biomarkers can be used to determine an estimated glomerular filtration rate (eGFR). CKD is classified into five stages6 based on estimated glomerular filtration rate (eGFR) and evidence of kidney damage (typically assessed as protein or albumin in the urine).The stages in CKD are classified primarily based on the estimated glomerular filtration rate (eGFR). Stages 1, 2, 3 and 4 have eGFR values of >90, 60 – 89, 30 – 59 and 15 – 29 mL/min/1.73m2 respectively. CKD stage 4 represents severe kidney damage. CKD stage 5, representing severe kidney damage or failing kidneys and also termed as end stage kidney disease (ESRD), is defined by eGFR below 15 mL/min/1.73m2 and includes individuals with kidney failure treated with dialysis. Treatment for CKD stage 5 patients is dialysis or kidney replacement therapy. There are two types of dialysis: hemodialysis and peritoneal dialysis. Hemodialysis involves circulating blood through an external dialyzer (filtering machine) for filtration. Peritoneal dialysis is performed within a patient’s body using the lining of the abdomen/peritoneum as a filter, and a dialysate or cleansing solution that is exchanged using a catheter.

Chronic oral diseases (COD) are a range of conditions that affect the mouth, including dental caries, gingival infection, periodontal disease, and tooth loss.4 These are among the most common chronic diseases in the United States and can have a significant impact on overall health. CODs can have significant impact on other organ systems with perhaps the most notable albeit rare example being untreated Streptococcus infections resulting in an infection-associated glomerulonephritis that can result in kidney failure.7 This connection extends beyond overt infectious pathology and far more often includes more commonplace factors that impact oral health including periodontitis, a polymicrobial inflammatory condition affecting 90% of adults worldwide to various degrees of severity. Severe periodontitis affects more than 15% of American adults,8 constituting a major cause of tooth loss and exacerbating various other conditions. Figure 1 shows a causal model schematically representing the relationship between CKD and COD.

Systemic inflammation is a known contributor to CKD disease progression,9 and periodontitis is a common cause of increased measures of a systemic inflammatory state.10 It is notable that the prevalence of periodontitis approaches 100% in patients on dialysis in some studies11 suggesting that this is a near-ubiquitous comorbidity with severe CKD. Indeed, recent findings have identified that periodontitis is a risk factor for eGFR decline, and dental intervention may reduce total medical treatment for these patients by delaying or preventing disease progression.12 Longitudinal studies suggest that these two diseases contribute to the progression of one another, so intervention at the level of the more readily treated disease (periodontitis) may offer significant advantages in total reduction of health and financial burdens.13 Some studies suggest that periodontitis may also significantly exacerbate cardiovascular risk and total mortality in patients with CKD at all severity levels.14

  1. National Institutes of Health. Oral Health Care in America: Advances and Challenges. Bethesda, MD: US Department of Health and Human Services, National Institutes of Health, National Institute of Dental and Craniofacial Research.; 2021.
  2. Kapila, Y. L. Oral Health’s Inextricable Connection to Systemic Health: Special Populations Bring to Bear Multimodal Relationships and Factors Connecting Periodontal Disease to Systemic Diseases and Conditions. Periodontol 2000 2021, 87 (1), 11–16. https://doi.org/10.1111/prd.12398.
  3. Centers for Disease Control and Prevention. Chronic Kidney Disease in the United States, 2023. Atlanta, Ga: Us Department of Health and Human Services, Centers for Disease Control and Prevention; 2023.; Centers for Disease Control and Prevention., 2023.
  4. Francis, A.; Harhay, M. N.; Ong, A. C. M.; Tummalapalli, S. L.; Ortiz, A.; Fogo, A. B.; Fliser, D.; Roy-Chaudhury, P.; Fontana, M.; Nangaku, M.; Wanner, C.; Malik, C.; Hradsky, A.; Adu, D.; Bavanandan, S.; Cusumano, A.; Sola, L.; Ulasi, I.; Jha, V.; American Society of Nephrology; European Renal Association; International Society of Nephrology. Chronic Kidney Disease and the Global Public Health Agenda: An International Consensus. Nat Rev Nephrol 2024, 20 (7), 473–485. https://doi.org/10.1038/s41581-024-00820-6.
  5. National Institute of Diabetes and Digestive and Kidney Diseases. Causes of Chronic Kidney Disease. Chronic Kidney Disease. https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/causes.
  6. American Kidney Fund. All about the kidneys. Stages of kidney disease (CKD). https://www.kidneyfund.org/all-about-kidneys/stages-kidney-disease (accessed 2024-07-21).
  7. Centers for Disease Control and Prevention. About Post-Streptococcal Glomerulonephritis. https://www.cdc.gov/group-a-strep/about/post-streptococcal-glomerulonephritis.html.
  8. National Institute of Dental and Cranofacial Research. Periodontal Disease in Adults (Age 30 or Older). https://www.nidcr.nih.gov/research/data-statistics/periodontal-disease/adults.
  9. Yan, Z.; Shao, T. Chronic Inflammation in Chronic Kidney Disease. Nephron 2024, 148 (3), 143–151. https://doi.org/10.1159/000534447.
  10. Martínez-García, M.; Hernández-Lemus, E. Periodontal Inflammation and Systemic Diseases: An Overview. Front Physiol 2021, 12, 709438. https://doi.org/10.3389/fphys.2021.709438.
  11. Craig, R. G. Interactions between Chronic Renal Disease and Periodontal Disease. Oral Dis 2008, 14 (1), 1–7. https://doi.org/10.1111/j.1601-0825.2007.01430.x.
  12. Grubbs, V.; Vittinghoff, E.; Beck, J. D.; Kshirsagar, A. V.; Wang, W.; Griswold, M. E.; Powe, N. R.; Correa, A.; Young, B. Association Between Periodontal Disease and Kidney Function Decline in African Americans: The Jackson Heart Study. Journal of Periodontology 2015, 86 (10), 1126–1132. https://doi.org/10.1902/jop.2015.150195.
  13. Sharma, P.; Fenton, A.; Dias, I. H. K.; Heaton, B.; Brown, C. L. R.; Sidhu, A.; Rahman, M.; Griffiths, H. R.; Cockwell, P.; Ferro, C. J.; Chapple, I. L.; Dietrich, T. Oxidative Stress Links Periodontal Inflammation and Renal Function. J Clin Periodontol 2021, 48 (3), 357–367. https://doi.org/10.1111/jcpe.13414.
  14. Sharma, P.; Dietrich, T.; Ferro, C. J.; Cockwell, P.; Chapple, I. L. C. Association between Periodontitis and Mortality in Stages 3-5 Chronic Kidney Disease: NHANES III and Linked Mortality Study. J Clin Periodontol 2016, 43 (2), 104–113. https://doi.org/10.1111/jcpe.12502.
  15. Sterne, J. A. C.; Savović, J.; Page, M. J.; Elbers, R. G.; Blencowe, N. S.; Boutron, I.; Cates, C. J.; Cheng, H.-Y.; Corbett, M. S.; Eldridge, S. M.; Emberson, J. R.; Hernán, M. A.; Hopewell, S.; Hróbjartsson, A.; Junqueira, D. R.; Jüni, P.; Kirkham, J. J.; Lasserson, T.; Li, T.; McAleenan, A.; Reeves, B. C.; Shepperd, S.; Shrier, I.; Stewart, L. A.; Tilling, K.; White,
  16. I. R.; Whiting, P. F.; Higgins, J. P. T. RoB 2: A Revised Tool for Assessing Risk of Bias in Randomised Trials. BMJ 2019, l4898. https://doi.org/10.1136/bmj.l4898.
  17. Sterne, J. A.; Hernán, M. A.; Reeves, B. C.; Savović, J.; Berkman, N. D.; Viswanathan, M.; Henry, D.; Altman, D. G.; Ansari, M. T.; Boutron, I.; Carpenter, J. R.; Chan, A.-W.; Churchill, R.; Deeks, J. J.; Hróbjartsson, A.; Kirkham, J.; Jüni, P.; Loke, Y. K.; Pigott, T. D.; Ramsay, C. R.; Regidor, D.; Rothstein, H. R.; Sandhu, L.; Santaguida, P. L.; Schünemann, H. J.; Shea, B.; Shrier, I.; Tugwell, P.; Turner, L.; Valentine, J. C.; Waddington, H.; Waters, E.; Wells, G. A.; Whiting, P. F.; Higgins, J. P. ROBINS-I: A Tool for Assessing Risk of Bias in Non-Randomised Studies of Interventions. BMJ 2016, i4919. https://doi.org/10.1136/bmj.i4919.
  18. Wells, G.; Shea, B.; O’Connell, J.; Robertson, J.; Peterson, V.; Welch, V. The NewcastleOttawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta-Analysis.
  19. Shea, B. J.; Reeves, B. C.; Wells, G.; Thuku, M.; Hamel, C.; Moran, J.; Moher, D.; Tugwell, P.; Welch, V.; Kristjansson, E.; Henry, D. A. AMSTAR 2: A Critical Appraisal Tool for Systematic Reviews That Include Randomised or Non-Randomised Studies of Healthcare Interventions, or Both. BMJ 2017, j4008. https://doi.org/10.1136/bmj.j4008.
    (19) KDIGO. Kidney Disease: Improving Global Outcomes (KDIGO) Kidney Transplant Candidate Work Group. KDIGO Clinical Practice Guideline on the Evaluation and Management of Candidates for Kidney Transplantation. Transplantation. 2020;104: S1–S103.
  20. American Dental Association. ADA’s Guidelines for Practice Success. https://www.ada.org/publications/guidelines-for-practice-success (accessed 2024-07-21).
  21. Covidence.
  22. Chiu, C.-C.; Chang, Y.-C.; Huang, R.-Y.; Chan, J.-S.; Chung, C.-H.; Chien, W.-C.; Kao, Y.-H.; Hsiao, P.-J. Investigation of the Impact of Endodontic Therapy on Survival among Dialysis Patients in Taiwan: A Nationwide Population-Based Cohort Study. Int J Environ Res Public Health 2021, 18 (1), 326. https://doi.org/10.3390/ijerph18010326.
  23. Delbove, T.; Gueyffier, F.; Juillard, L.; Kalbacher, E.; Maucort-Boulch, D.; Nony, P.; Grosgogeat, B.; Gritsch, K. Effect of Periodontal Treatment on the Glomerular Filtration Rate, Reduction of Inflammatory Markers and Mortality in Patients with Chronic Kidney Disease: A Systematic Review. PLoS One 2021, 16 (1), e0245619. https://doi.org/10.1371/journal.pone.0245619.
  24. da Silva, T. A.; Abreu, L. G.; Esteves Lima, R. P. A Meta-Analysis on the Effect of Periodontal Treatment on the Glomerular Filtration Rate of Chronic Kidney Disease Individuals: A Systematic Review and Meta-Analysis Was Conducted to Assess the Impact of the Periodontal Treatment on the Glomerular Filtration Rate of Individuals with Chronic Kidney Disease. Spec Care Dentist 2021, 41 (6), 670–678. https://doi.org/10.1111/scd.12625.
  25. Zhao, D.; Khawaja, A. T.; Jin, L. Effect of Non-Surgical Periodontal Therapy on Renal Function in Chronic Kidney Disease Patients with Periodontitis: A Systematic Re and Meta-Analysis of Interventional Studies. Clin Oral Investig 2020, 24, 1607–1618.
  26. Vachhani, K. S.; Bhavsar, N. V. Effects of Non-Surgical Periodontal Therapy on Serum Inflammatory Factor High-Sensitive C-Reactive Protein, Periodontal Parameters and Renal Biomarkers in Patients with Chronic Periodontitis and Chronic Kidney Disease. Dent Med Probl 2021, 58 (4), 489–498. https://doi.org/10.17219/dmp/136034.
  27. Deschamps-Lenhardt, S.; Martin-Cabezas, R.; Hannedouche, T.; Huck, O. Association between Periodontitis and Chronic Kidney Disease: Systematic Re and Meta-Analysis. Oral Dis 2019, 25, 385–402.
  28. Maheshwari, S.; Chahal, G. S.; Grover, V.; Rathi, M.; Sharma, R.; Sharma, R.; Jain, A. Impact of Periodontal Treatment on Inflammatory Oxidative Stress in Chronic Kidney Disease Subjects: An Interventional Clinical Trial. Am J Dent 2023, 36 (1), 15–20.
  29. Bezerra, P. L.; de Carvalho Júnior, A. D.; da Silva, A. F.; Pereira, N. E. G.; da Costa, S. R. R.; de Sousa, J. N. L.; Bernardino, Í. de M. Effects of Periodontal Treatment on the C-Reactive Protein Levels in Hemodialysis Patients: A Systematic Review and Meta-Analysis. Spec Care Dentist 2024, 44 (1), 28–39. https://doi.org/10.1111/scd.12834.
  30. Lai, J.; Bai, Y.-L.; Bai, Y.; Mei, J.; Zhang, Z.-W.; Tang, W.-J.; Huang, J. [A Meta-analysis of the effect of non-surgical periodontal therapy on inflammatory factors in patients with chronic kidney disease and periodontitis]. Hua Xi Kou Qiang Yi Xue Za Zhi 2020, 38 (6), 672–680. https://doi.org/10.7518/hxkq.2020.06.012.
  31. Vrinda, S.; Sadasivan, A.; Koshi, E.; Unnikrishnan, B.; Chandradas, N.; Saraswathi, I. Effect of Nonsurgical Periodontal Therapy on C-Reactive Protein and Iron Indices in Hemodialysis Patients. J Indian Soc Periodontol 2021, 25 (6), 485. https://doi.org/10.4103/jisp.jisp_32_20.
  32. Rapone, B.; Ferrara, E.; Qorri, E.; Quadri, M. F. A.; Dipalma, G.; Mancini, A.; Del Fabbro, M.; Scarano, A.; Tartaglia, G.; Inchingolo, F. Intensive Periodontal Treatment Does Not Affect the Lipid Profile and Endothelial Function of Patients with Type 2 Diabetes: A Randomized Clinical Trial. Biomedicines 2022, 10 (10). https://doi.org/10.3390/biomedicines10102524.
  33. Fang, F.; Wu, B.; Qu, Q. The Clinical Response and Systemic Effects of Non-Surgical Periodontal Therapy in End-Stage Renal Disease Patients: A 6-Month Randomized Controlled Clinical Trial. J Clin Periodontol 2015, 42, 537–546.
  34. Yue, H.; Xu, X.; Liu, Q.; Li, X.; Xiao, Y.; Hu, B. Effects of Non-Surgical Periodontal Therapy on Systemic Inflammation and Metabolic Markers in Patients Undergoing Haemodialysis and/or Peritoneal Dialysis: A Systematic Review and Meta-Analysis. BMC Oral Health 2020, 20 (1), 18. https://doi.org/10.1186/s12903-020-1004-1.
  35. Palmer, S. C.; Ruospo, M.; Wong, G.; Craig, J. C.; Petruzzi, M.; De Benedittis, M.; Ford, P.; Johnson, D. W.; Tonelli, M.; Natale, P.; Saglimbene, V.; Pellegrini, F.; Celia, E.; Gelfman, R.; Leal, M. R.; Torok, M.; Stroumza, P.; Bednarek-Skublewska, A.; Dulawa, J.; Frantzen, L.; Ferrari, J. N.; Del Castillo, D.; Bernat, A. G.; Hegbrant, J.; Wollheim, C.; Gargano, L.; Bots, C. P.; Strippoli, G. F. M.; ORAL-D Study Investigators. Dental Health and Mortality in People With End-Stage Kidney Disease Treated With Hemodialysis: A Multinational Cohort Study. Am J Kidney Dis 2015, 66 (4), 666–676. https://doi.org/10.1053/j.ajkd.2015.04.051.
  36. Santos-Paul, M. A.; Neves, R. S.; Gowdak, L. H. W.; de Paula, F. J.; David-Neto, E.; Bortolotto, L. A.; Ramires, J. A. F.; De Lima, J. J. G. Cardiovascular Risk Reduction with Periodontal Treatment in Patients on the Waiting List for Renal Transplantation. Clin Transplant 2019, 33 (8), e13658. https://doi.org/10.1111/ctr.13658.
  37. Huang, S.-T.; Yu, T.-M.; Ke, T.-Y.; Wu, M.-J.; Chuang, Y.-W.; Li, C.-Y.; Chiu, C.-W.; Lin, C.-L.; Liang, W.-M.; Chou, T.-C.; Kao, C.-H. Intensive Periodontal Treatment Reduces Risks of Hospitalization for Cardiovascular Disease and All-Cause Mortality in the Hemodialysis Population. J Clin Med 2018, 7 (10), 344. https://doi.org/10.3390/jcm7100344.
  38. Chung, W.-C.; Kao, C.-C.; Huang, C.-F.; Lee, C.-Y.; Lu, H.-K.; Wu, M.-S. Effects of Periodontal Treatment in Patients with Periodontitis and Kidney Failure: A Pilot Study. Int J Environ Res Public Health 2022, 19 (3), 1533. https://doi.org/10.3390/ijerph19031533.
  39. Huang, S.-T.; Lin, C.-L.; Yu, T.-M.; Wu, M.-J.; Kao, C.-H. Intensive Periodontal Treatment Reduces Risk of Infection-Related Hospitalization in Hemodialysis Population: A Nationwide Population-Based Cohort Study. Medicine (Baltimore) 2015, 94 (34), e1436. https://doi.org/10.1097/MD.0000000000001436.
  40. Yu, I.-C.; Chang, S.-H.; Hong, H.-H.; Huang, Y.-T.; Fang, J.-T. The Risk of Endocarditis in Hemodialysis Patients Who Have Undergone Invasive Dental Treatment: A Cohort Case-Control Analysis of the Taiwan National Health Insurance Database. Clin Oral Investig 2023, 27 (1), 203–211. https://doi.org/10.1007/s00784-022-04711-7.
  41. de Souza, C. M.; Braosi, A. P. R.; Luczyszyn, S. M.; Olandoski, M.; Kotanko, P.; Craig, R. G.; Trevilatto, P. C.; Pecoits-Filho, R. Association among Oral Health Parameters, Periodontitis, and Its Treatment and Mortality in Patients Undergoing Hemodialysis. J Periodontol 2014, 85 (6), e169-178. https://doi.org/10.1902/jop.2013.130427.
  42. Siribamrungwong, M.; Yothasamutr, K.; Puangpanngam, K. Periodontal Treatment Reduces Chronic Systemic Inflammation in Peritoneal Dialysis Patients. Ther Apher Dial 2014, 18 (3), 305–308. https://doi.org/10.1111/1744-9987.12105.
  43. Kocyigit, I.; Yucel, H. E.; Cakmak, O.; Dogruel, F.; Durukan, D. B.; Korkar, H.; Unal, A.; Sipahioglu, M. H.; Oymak, O.; Gurgan, C. A.; Tokgoz, B. An Ignored Cause of Inflammation in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis: Periodontal Problems. Int Urol Nephrol 2014, 46 (10), 2021–2028. https://doi.org/10.1007/s11255-014-0716-z.
  44. Rapone, B.; Converti, I.; Santacroce, L.; Cesarano, F.; Vecchiet, F.; Cacchio, L.; Scacco, S.; Grassi, R.; Grassi, F. R.; Gnoni, A.; Nardi, G. M. Impact of Periodontal Inflammation on Nutrition and Inflammation Markers in Hemodialysis Patients. Antibiotics (Basel) 2019, 8 (4), 209. https://doi.org/10.3390/antibiotics8040209.
  45. NICE guideline. Chronic Kidney Disease: Assessment and Management; 2021. https://www.nice.org.uk/guidance/ng203/resources/chronic-kidney-disease-assessment-and-management-pdf-66143713055173 (accessed 2024-07-09).
  46. Farrington, K.; Covic, A.; Nistor, I.; Aucella, F.; Clyne, N.; De Vos, L.; Findlay, A.; Fouque, D.; Grodzicki, T.; Iyasere, O.; Jager, K. J.; Joosten, H.; Macias, J. F.; Mooney, A.; Nagler, E.; Nitsch, D.; Taal, M.; Tattersall, J.; Stryckers, M.; Van Asselt, D.; Van Den Noortgate, N.; Van Der Veer, S.; Van Biesen, W. Clinical Practice Guideline on Management of Older Patients with Chronic Kidney Disease Stage 3b or Higher (eGFR<45 mL/Min/1.73 M2): A Summary Document from the European Renal Best Practice Group. Nephrology Dialysis Transplantation 2017, 32 (1), 9–16. https://doi.org/10.1093/ndt/gfw411.
  47. Howell, S.; Perry, M. M.; Patel, N. Protocols for Treating Patients with End‐stage Renal Disease: A Survey of AEGD/GPR Dental Residencies. Special Care in Dentistry 2016, 36 (6), 325–327. https://doi.org/10.1111/scd.12194.
  48. Perry, M. M.; Howell, S.; Patel, N. Protocols for Treating Patients with End‐stage Renal Disease: A Survey of Nephrology Fellowships. Special Care in Dentistry 2017, 37 (2), 57–61. https://doi.org/10.1111/scd.12211.
  49. Sturgill, J.; Howell, S.; Perry, M. M.; Kothari, H. Protocols for Treating Patients with End‐stage Renal Disease: A Survey of Undergraduate Dental Programs. Special Care in Dentistry 2016, 36 (6), 321–324. https://doi.org/10.1111/scd.12197.
  50. Kapellas, K.; Singh, A.; Bertotti, M.; Nascimento, G. G.; Jamieson, L. M.; on behalf of the Perio‐CKD collaboration. Periodontal and Chronic Kidney Disease Association: A Systematic Review and Meta‐analysis. Nephrology 2019, 24 (2), 202–212. https://doi.org/10.1111/nep.13225.
  51. Graterol Torres, F.; Molina, M.; Soler-Majoral, J.; Romero-González, G.; Rodríguez Chitiva, N.; Troya-Saborido, M.; Socias Rullan, G.; Burgos, E.; Paúl Martínez, J.; Urrutia Jou, M.; Cañameras, C.; Riera Sadurní, J.; Vila, A.; Bover, J. Evolving Concepts on Inflammatory Biomarkers and Malnutrition in Chronic Kidney Disease. Nutrients 2022, 14 (20), 4297. https://doi.org/10.3390/nu14204297.
  52. Diabetes and Oral Health. https://www.cdc.gov/diabetes/managing/diabetes-oral-health.html (accessed 2024-04-23).
  53. United States Renal Data System. 2020 USRDS Annual Data Report: Epidemiology of Kidney Disease in the United States. Bethesda, MD, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, 2020; 2020.
  54. Kidney Disease Basics. https://www.cdc.gov/kidneydisease/basics.html (accessed 2024-04-23).
  55. National Library of Medicine. Clinical Trials Database. https://clinicaltrials.gov.

Project Timeline

Linking Dental Services to Treatment Outcomes for Chronic Kidney Disease: A Rapid Response Review July 2024

Oct 30, 2024
Topic Initiated
Nov 1, 2024
Rapid Evidence Product
Page last reviewed October 2024
Page originally created October 2024

Internet Citation: Rapid Evidence Product: Linking Dental Services to Treatment Outcomes for Chronic Kidney Disease: A Rapid Response Review. Content last reviewed October 2024. Effective Health Care Program, Agency for Healthcare Research and Quality, Rockville, MD.
https://effectivehealthcare.ahrq.gov/products/treatment-outcomes-chronic-kidney/rapid-research

Select to copy citation