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            <front>

                <journal-meta>
                                                                <journal-id>j health sci med / jhsm</journal-id>
            <journal-title-group>
                                                                                    <journal-title>Journal of Health Sciences and Medicine</journal-title>
            </journal-title-group>
                                        <issn pub-type="epub">2636-8579</issn>
                                                                                            <publisher>
                    <publisher-name>MediHealth Academy Yayıncılık</publisher-name>
                </publisher>
                    </journal-meta>
                <article-meta>
                                        <article-id pub-id-type="doi">10.32322/jhsm.1851652</article-id>
                                                                <article-categories>
                                            <subj-group  xml:lang="en">
                                                            <subject>Periodontics</subject>
                                                            <subject>Nefroloji</subject>
                                                    </subj-group>
                                            <subj-group  xml:lang="tr">
                                                            <subject>Periodontoloji</subject>
                                                            <subject>Nefroloji</subject>
                                                    </subj-group>
                                    </article-categories>
                                                                                                                                                        <title-group>
                                                                                                                        <article-title>Awareness, perceptions, and clinical practice approaches of nephrologists toward the periodontal disease–chronic kidney disease association</article-title>
                                                                                                    </title-group>
            
                                                    <contrib-group content-type="authors">
                                                                        <contrib contrib-type="author">
                                                                    <contrib-id contrib-id-type="orcid">
                                        https://orcid.org/0000-0002-3286-7819</contrib-id>
                                                                <name>
                                    <surname>Ceylan Şen</surname>
                                    <given-names>Seval</given-names>
                                </name>
                                                                    <aff>UNIVERSITY OF HEALTH SCIENCES, GÜLHANE FACULTY OF DENTISTRY (ANKARA)</aff>
                                                            </contrib>
                                                    <contrib contrib-type="author">
                                                                    <contrib-id contrib-id-type="orcid">
                                        https://orcid.org/0000-0002-2964-8244</contrib-id>
                                                                <name>
                                    <surname>Saraç Atagün</surname>
                                    <given-names>Özlem</given-names>
                                </name>
                                                                    <aff>UNIVERSITY OF HEALTH SCIENCES</aff>
                                                            </contrib>
                                                    <contrib contrib-type="author">
                                                                    <contrib-id contrib-id-type="orcid">
                                        https://orcid.org/0000-0002-4205-861X</contrib-id>
                                                                <name>
                                    <surname>Ustaoğlu</surname>
                                    <given-names>Gülbahar</given-names>
                                </name>
                                                                    <aff>UNIVERSITY OF HEALTH SCIENCES</aff>
                                                            </contrib>
                                                    <contrib contrib-type="author">
                                                                    <contrib-id contrib-id-type="orcid">
                                        https://orcid.org/0000-0001-6204-7304</contrib-id>
                                                                <name>
                                    <surname>Paksoy</surname>
                                    <given-names>Tuğçe</given-names>
                                </name>
                                                                    <aff>UNIVERSITY OF HEALTH SCIENCES</aff>
                                                            </contrib>
                                                    <contrib contrib-type="author">
                                                                    <contrib-id contrib-id-type="orcid">
                                        https://orcid.org/0000-0002-3633-9546</contrib-id>
                                                                <name>
                                    <surname>Kadıoğlu Koçak</surname>
                                    <given-names>Meral Gülay</given-names>
                                </name>
                                                                    <aff>SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İSTANBUL OKMEYDANI SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ</aff>
                                                            </contrib>
                                                                                </contrib-group>
                        
                                        <pub-date pub-type="pub" iso-8601-date="20260312">
                    <day>03</day>
                    <month>12</month>
                    <year>2026</year>
                </pub-date>
                                        <volume>9</volume>
                                        <issue>2</issue>
                                        <fpage>544</fpage>
                                        <lpage>551</lpage>
                        
                        <history>
                                    <date date-type="received" iso-8601-date="20251229">
                        <day>12</day>
                        <month>29</month>
                        <year>2025</year>
                    </date>
                                                    <date date-type="accepted" iso-8601-date="20260311">
                        <day>03</day>
                        <month>11</month>
                        <year>2026</year>
                    </date>
                            </history>
                                        <permissions>
                    <copyright-statement>Copyright © 2018, Journal of Health Sciences and Medicine</copyright-statement>
                    <copyright-year>2018</copyright-year>
                    <copyright-holder>Journal of Health Sciences and Medicine</copyright-holder>
                </permissions>
            
                                                                                                <abstract><p>Aims: Periodontitis is a chronic inflammatory condition implicated in the pathogenesis of systemic diseases, including chronic kidney disease (CKD), primarily through low-grade systemic inflammatory pathways. Given the potential impact of periodontal health on CKD progression, this study aims to assess nephrologists’ awareness, attitudes, and clinical practices regarding the association between periodontal disease and CKD. Methods: This cross-sectional study used a structured, literature-based questionnaire distributed via Google Forms to nephrologists. Participation was voluntary, and informed consent was obtained online. The survey included demographic questions and items assessing awareness, attitudes, and clinical practice approaches regarding the interrelationship between periodontal disease and CKD. A total of 144 nephrologists completed the survey. Multivariable binary logistic regression was employed to identify independent predictors of participants&#039; oral health education status.Results: Of the 144 nephrologists surveyed, most were aged 45–54 years, had 11–20 years of experience, and worked in university hospitals following over 100 CKD patients monthly. While general awareness of the oral–renal connection was moderate to high, many participants did not routinely take oral health histories or recognize uremic manifestations. Nonetheless, the majority reported referring patients with oral complaints to dentists. Prior training in oral health and recent dental visits were associated with higher awareness and more positive attitudes. Regression analysis identified age as a significant predictor of prior training, with nephrologists aged 35–44 and 55+ being 7.4 times more likely to have received oral health education (p=0.036).Conclusion: Since age was identified as a significant predictor of prior training, with younger nephrologists being less likely to have received oral health education, targeted interdisciplinary programs focusing on early-career specialists are essential to bridge this knowledge gap. Furthermore, the inverse relationship between educational opinions and prior training emphasizes a strong perceived need for such interventions among untrained professionals.</p></abstract>
                                                            
            
                                                            <kwd-group>
                                                    <kwd>Periodontitis</kwd>
                                                    <kwd>  chronic kidney disease</kwd>
                                                    <kwd>  nephrologists</kwd>
                                                    <kwd>  awareness</kwd>
                                                    <kwd>  survey</kwd>
                                            </kwd-group>
                            
                                                                                                                    <funding-group specific-use="FundRef">
                    <award-group>
                                                    <funding-source>
                                <named-content content-type="funder_name">The authors did not receive support from any organization for the submitted work.</named-content>
                            </funding-source>
                                                                            <award-id>None</award-id>
                                            </award-group>
                </funding-group>
                                </article-meta>
    </front>
    <back>
                            <ref-list>
                                    <ref id="ref1">
                        <label>1</label>
                        <mixed-citation publication-type="journal">Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: framework and proposal of a new classification and case definition. J Periodontol. 2018;89(Suppl 1):S159-s172. doi:10.1002/jper. 18-0006</mixed-citation>
                    </ref>
                                    <ref id="ref2">
                        <label>2</label>
                        <mixed-citation publication-type="journal">Mehrotra N, Singh S. Periodontitis. StatPearls. StatPearls Publishing. Copyright © 2025, StatPearls Publishing LLC.; 2025.</mixed-citation>
                    </ref>
                                    <ref id="ref3">
                        <label>3</label>
                        <mixed-citation publication-type="journal">Shoji T, Abe T, Matsuo H, et al. Chronic kidney disease, dyslipidemia, and atherosclerosis. J Atheroscler Thromb. 2012;19(4):299-315. doi:10. 5551/jat.10454</mixed-citation>
                    </ref>
                                    <ref id="ref4">
                        <label>4</label>
                        <mixed-citation publication-type="journal">Büberci R, Duranay M. Risk factors for chronic kidney disease progression in patients with solitary kidney. J Health Sci Med. 2022;5(3): 342-347. doi:10.32322/jhsm.1009811</mixed-citation>
                    </ref>
                                    <ref id="ref5">
                        <label>5</label>
                        <mixed-citation publication-type="journal">Luyckx VA, Tuttle KR, Garcia-Garcia G, et al. Reducing major risk factors for chronic kidney disease. Kidney Int Suppl (2011). 2017;7(2):71-87. doi:10.1016/j.kisu.2017.07.003</mixed-citation>
                    </ref>
                                    <ref id="ref6">
                        <label>6</label>
                        <mixed-citation publication-type="journal">Loos BG. Systemic markers of inflammation in periodontitis. J Periodontol. 2005;76(11 Suppl):2106-2115. doi:10.1902/jop.2005.76.11-S. 2106</mixed-citation>
                    </ref>
                                    <ref id="ref7">
                        <label>7</label>
                        <mixed-citation publication-type="journal">Kshirsagar AV, Moss KL, Elter JR, Beck JD, Offenbacher S, Falk RJ. Periodontal disease is associated with renal insufficiency in the Atherosclerosis Risk In Communities (ARIC) study. Am J Kidney Dis. 2005;45(4):650-657. doi:10.1053/j.ajkd.2004.12.009</mixed-citation>
                    </ref>
                                    <ref id="ref8">
                        <label>8</label>
                        <mixed-citation publication-type="journal">Fisher MA, Taylor GW, Shelton BJ, et al. Periodontal disease and other nontraditional risk factors for CKD. Am J Kidney Dis. 2008;51(1):45-52. doi:10.1053/j.ajkd.2007.09.018</mixed-citation>
                    </ref>
                                    <ref id="ref9">
                        <label>9</label>
                        <mixed-citation publication-type="journal">Deschamps-Lenhardt S, Martin-Cabezas R, Hannedouche T, Huck O. Association between periodontitis and chronic kidney disease: systematic review and meta-analysis. Oral Dis. 2019;25(2):385-402. doi: 10.1111/odi.12834</mixed-citation>
                    </ref>
                                    <ref id="ref10">
                        <label>10</label>
                        <mixed-citation publication-type="journal">Schütz JDS, de Azambuja CB, Cunha GR, et al. Association between severe periodontitis and chronic kidney disease severity in predialytic patients: a cross-sectional study. Oral Dis. 2020;26(2):447-456. doi:10. 1111/odi.13236</mixed-citation>
                    </ref>
                                    <ref id="ref11">
                        <label>11</label>
                        <mixed-citation publication-type="journal">Parsegian K, Randall D, Curtis M, Ioannidou E. Association between periodontitis and chronic kidney disease. Periodontol 2000. 2022;89(1): 114-124. doi:10.1111/prd.12431</mixed-citation>
                    </ref>
                                    <ref id="ref12">
                        <label>12</label>
                        <mixed-citation publication-type="journal">Cohen L, Schaeffer M, Davideau JL, Tenenbaum H, Huck O. Obstetric knowledge, attitude, and behavior concerning periodontal diseases and treatment needs in pregnancy: influencing factors in France. J Periodontol. 2015;86(3):398-405. doi:10.1902/jop.2014.140371</mixed-citation>
                    </ref>
                                    <ref id="ref13">
                        <label>13</label>
                        <mixed-citation publication-type="journal">Fisher MA, Taylor GW, West BT, McCarthy ET. Bidirectional relationship between chronic kidney and periodontal disease: a study using structural equation modeling. Kidney Int. 2011;79(3):347-355. doi: 10.1038/ki.2010.384</mixed-citation>
                    </ref>
                                    <ref id="ref14">
                        <label>14</label>
                        <mixed-citation publication-type="journal">Kaymaz K, Brunet-Llobet L, Rocha-Eiroa MD, et al. Patient-related factors that link chronic kidney disease and periodontitis: a scoping review. Odontology. 2025;113(3):865-877. doi:10.1007/s10266-024-01031-y</mixed-citation>
                    </ref>
                                    <ref id="ref15">
                        <label>15</label>
                        <mixed-citation publication-type="journal">Kapellas K, Singh A, Bertotti M, Nascimento GG, Jamieson LM. Periodontal and chronic kidney disease association: a systematic review and meta-analysis. Nephrology (Carlton). 2019;24(2):202-212. doi:10. 1111/nep.13225</mixed-citation>
                    </ref>
                                    <ref id="ref16">
                        <label>16</label>
                        <mixed-citation publication-type="journal">Lertpimonchai A, Rattanasiri S, Tamsailom S, et al. Periodontitis as the risk factor of chronic kidney disease: mediation analysis. J Clin Periodontol. 2019;46(6):631-639. doi:10.1111/jcpe.13114</mixed-citation>
                    </ref>
                                    <ref id="ref17">
                        <label>17</label>
                        <mixed-citation publication-type="journal">Iwasaki M, Taylor GW, Sato M, Minagawa K, Ansai T, Yoshihara A. Effect of chronic kidney disease on progression of clinical attachment loss in older adults: a 4-year cohort study. J Periodontol. 2019;90(8):826-833. doi:10.1002/jper.18-0464</mixed-citation>
                    </ref>
                                    <ref id="ref18">
                        <label>18</label>
                        <mixed-citation publication-type="journal">Bastos Jdo A, Vilela EM, Henrique MN, et al. Assessment of knowledge toward periodontal disease among a sample of nephrologists and nurses who work with chronic kidney disease not yet on dialysis. J Bras Nefrol. 2011;33(4):431-435.</mixed-citation>
                    </ref>
                                    <ref id="ref19">
                        <label>19</label>
                        <mixed-citation publication-type="journal">Wallace CK, Vernazza CR, Emmet V, et al. Evaluation of UK paediatric nephrology teams&#039; understanding, experience and perceptions of oral health outcomes and accessibility to dental care: a mixed-methods study. Pediatr Nephrol. 2024;39(7):2131-2138. doi:10.1007/s00467-024-06292-x</mixed-citation>
                    </ref>
                                    <ref id="ref20">
                        <label>20</label>
                        <mixed-citation publication-type="journal">Umeizudike KA, Iwuala SO, Ozoh OB, Ekekezie OO, Umeizudike TI. Periodontal systemic interaction: perception, attitudes and practices among medical doctors in Nigeria. J West Afr Coll Surg. 2015;5(2):43-65.</mixed-citation>
                    </ref>
                                    <ref id="ref21">
                        <label>21</label>
                        <mixed-citation publication-type="journal">Blue C, Isringhausen K, Dils E. Raising oral health awareness among nephrology nurses. J Dent Hyg. 2011;85(2):151-157.</mixed-citation>
                    </ref>
                                    <ref id="ref22">
                        <label>22</label>
                        <mixed-citation publication-type="journal">Abed H, Burke M, Shaheen F. The integrated care pathway of nephrology and dental teams to manage complex renal and postkidney transplant patients in dentistry: a holistic approach. Saudi J Kidney Dis Transpl. 2018;29(4):766-774. doi:10.4103/1319-2442.239634</mixed-citation>
                    </ref>
                                    <ref id="ref23">
                        <label>23</label>
                        <mixed-citation publication-type="journal">Piekoszewska-Ziętek P, Pańczyk-Tomaszewska M, Olczak-Kowalczyk D. Evaluation of oral hygiene and gingival parameters in pediatric nephrotic syndrome within an interdisciplinary care model. Sci Rep. 2025;15(1):21735. doi:10.1038/s41598-025-06687-2</mixed-citation>
                    </ref>
                                    <ref id="ref24">
                        <label>24</label>
                        <mixed-citation publication-type="journal">Anuradha BR, Katta S, Kode VS, et al. Oral and salivary changes in patients with chronic kidney disease: a clinical and biochemical study. J Indian Soc Periodontol. 2015;19(3):297-301. doi:10.4103/0972-124x. 154178</mixed-citation>
                    </ref>
                                    <ref id="ref25">
                        <label>25</label>
                        <mixed-citation publication-type="journal">Marinoski J, Bokor-Bratic M, Mitic I, Cankovic M. Oral mucosa and salivary findings in non-diabetic patients with chronic kidney disease. Arch Oral Biol. 2019;102:205-211. doi:10.1016/j.archoralbio.2019.04.021</mixed-citation>
                    </ref>
                                    <ref id="ref26">
                        <label>26</label>
                        <mixed-citation publication-type="journal">Honarmand M, Farhad-Mollashahi L, Nakhaee A, Sargolzaie F. Oral manifestation and salivary changes in renal patients undergoing hemodialysis. J Clin Exp Dent. 2017;9(2):e207-e210. doi:10.4317/jced. 53215</mixed-citation>
                    </ref>
                                    <ref id="ref27">
                        <label>27</label>
                        <mixed-citation publication-type="journal">Andrade MR, Antunes LA, Soares RM, Leão AT, Maia LC, Primo LG. Lower dental caries prevalence associated to chronic kidney disease: a systematic review. Pediatr Nephrol. 2014;29(5):771-778. doi:10.1007/s00467-013-2437-4</mixed-citation>
                    </ref>
                                    <ref id="ref28">
                        <label>28</label>
                        <mixed-citation publication-type="journal">Akar H, Akar GC, Carrero JJ, Stenvinkel P, Lindholm B. Systemic consequences of poor oral health in chronic kidney disease patients. Clin J Am Soc Nephrol. 2011;6(1):218-26. doi:10.2215/cjn.05470610</mixed-citation>
                    </ref>
                                    <ref id="ref29">
                        <label>29</label>
                        <mixed-citation publication-type="journal">Gaál Kovalčíková A, Pančíková A, Konečná B, et al. Urea and creatinine levels in saliva of patients with and without periodontitis. Eur J Oral Sci. 2019;127(5):417-424. doi:10.1111/eos.12642</mixed-citation>
                    </ref>
                                    <ref id="ref30">
                        <label>30</label>
                        <mixed-citation publication-type="journal">Wahid A, Chaudhry S, Ehsan A, Butt S, Ali Khan A. Bidirectional relationship between chronic kidney disease &amp; periodontal disease. Pak J Med Sci. 2013;29(1):211-215. doi:10.12669/pjms.291.2926</mixed-citation>
                    </ref>
                            </ref-list>
                    </back>
    </article>
