This investigation is aimed to assess the prevalence and severity of apical periodontitis (AP) in different stages of CKD patients and its impact on the systemic (nutritional and inflammatory) markers was compared to healthy individuals.

105 CKD patients (35 early (EG), 35pre-dialysis (PDG) and 35 hemodialysis (HDG)groups and 105 age and gender matched healthy controls were assessed for prevalence and severity of apical periodontitis and oral disease burden . Inflammatory (hsCRP and ferritin) and nutritional (urea and creatinine) markers were estimated and eGFR was calculated for the study population. Logistic regression was used to determine the possible association between CKD and AP in study population and Linear regression was performed to evaluate the possible association between systemic markers and endodontic burden (EB) in experimental group.

Inclusion Criteria:

• Known patient of CKD Stages 1,2,3,4 & 5 with estimated glomerular filtration rate [eGFR; MDRD] with mature permanent teeth.
• > 18 years
• > 8 natural teeth.
• Complete medical & dental history including panoramic radiographs of maxilla & mandible

Exclusion Criteria:

• Patients having systemic disorders other than CKD (eg HIV, Diabetes mellitus, Coronary heart disease, history of secondary hyperparathyroidism).
• Pregnancy, lactation & contraceptives.
• Systemic conditions that contra indicates dental treatment.
• Use of antibiotics & anti-inflammatory in last 3 months
• Need for antibiotic prophylaxis.
• Hepatitis C and B virus.
• Patients on steroids.

CKD patients of different levels (Stage 1 to Stage 5) with age and gender matched controls will be enrolled in the study.