Epidemiological association between periodontal disease and N02-coded recurrent and persistent hematuria: a retrospective cohort study

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Objectives: To evaluate the longitudinal association between periodontal disease (PD) and incident ICD-10 N02-coded recurrent and persistent hematuria (RPH), a claims-based indicator of early glomerular injury, over 11 years of follow-up and to assess whether this association was modified by diabetes mellitus (DM). Methods: This retrospective cohort study used data from the National Health Insurance Service–National Sample Cohort from 2002 to 2015. A total of 208,047 adults were followed for incident N02-coded RPH. Baseline PD, diabetes, and outcome events were identified using ICD-10 codes. Cox proportional hazards models were sequentially adjusted for sociodemographic factors, lifestyle behaviors, and cardiometabolic comorbidities. Results: Kaplan–Meier analysis showed significantly lower RPH-free survival among individuals with PD, with a more pronounced divergence among individuals with DM. In an unadjusted analysis, PD was associated with an increased hazard of incident ICD-10 N02-coded RPH in both individuals with and without DM. However, after full covariate adjustment, the association remained statistically significant only among individuals with DM (adjusted hazard ratio = 1.17, 95% confidence interval [CI] = 1.02–1.35). In contrast, no significant association was observed in individuals without DM. Conclusions: PD was associated with incident ICD-10 N02-coded RPH only in individuals with concurrent diabetes after full adjustment. These findings suggest a modest epidemiological association between PD and claims-based indicators of early glomerular injury in adults with diabetes. Because ICD-10 N02 is a nonspecific proxy outcome, these results should be interpreted cautiously.

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