Mr Sharma is currently investigating non-traditional risk factors impacting on morbidity and mortality in patients with Chronic Kidney Disease (CKD) in collaboration with the Renal Research Group at University Hospital Birmingham Foundation Trust (UHBFT). This is an on-going, prospective, detailed bioclinical study which aims to recruit 1000 pre-dialysis patients at risk of progressive CKD and with an increased cardiovascular risk and follow them up for 10 years (RIISC (Renal Impairment In Secondary Care) study
In his analysis of this cohort, he found significantly greater prevalence and severity of periodontitis amongst patients within the RIISC cohort compared to a control population, controlling for some confounders.
In investigating the association between worsening periodontal health and renal health, measures of worsening periodontal health were significantly positively associated with decreasing kidney function and increasing arterial stiffness in a multiple linear regression model.
These data show that not only do patients with CKD have a greater prevalence and severity of periodontitis than individuals without CKD but that worsening periodontal health in patients with CKD is associated with decreasing eGFR and increasing arterial stiffness.
Praveen also analysed data from a large, US dataset, (NHANES III) to find that patients with CKD and periodontitis had an approximate 10% increase in 10 year mortality, an increase similar to that seen in patients with CKD and diabetes, who were periodontally healthy.
In addition to these, Praveen analysed data from a UK based database, Denplan DEPPA, to show that periodontitis was associated with worse systemic health and more patient-reported outcomes of pain, difficulty eating and aesthetic concerns. Successful management of periodontitis was associated with an improvement in these outcomes.
These findings have been disseminated in regional, national and international meetings in the fields of dentistry and renal medicine as a mix of poster and oral presentations which have been very well received.