AbstractBackgroundAcute kidney injury (AKI) is characterized by rapid renal decline. Periodontitis, a chronic oral inflammatory disease, is increasingly associated with renal dysfunction. Although periodontitis is recognized as a contributor to kidney damage, the mechanisms linking it to AKI remain unclear.MethodsThis study explored the effects of Porphyromonas gingivalis (P. gingivalis) W83‐infected periodontitis on AKI in C57BL/6J mice, using ischemia‐reperfusion injury 55 days post‐infection. Gingipain inhibitors, KYT‐1 and KYT‐36, were applied. Detection of P. gingivalis was performed using quantitative real‐time polymerase chain reaction (qRT‐PCR) and PCR, while transcriptome sequencing, qRT‐PCR, immunohistochemistry, and immunofluorescence staining assessed renal damage. In vitro, HK‐2 cells were exposed to P. gingivalis at a multiplicity of infection of 10 for 48 h, with inhibition by gingipain or oncostatin M (OSM). Disruption of tight junctions (TJs) was quantified using qRT‐PCR, transepithelial electrical resistance, and cell counting kit‐8 assays.ResultsPeriodontitis worsened AKI, linked to P. gingivalis infection and renal TJ disruption in the kidney. P. gingivalis infection activated OSM expression, which correlated positively with gingipain. Significantly, OSM and gingipain might collaboratively contribute to the damage of renal TJs, with the reduced expression of TJ proteins. Suppressing gingipain activity presented itself as a protective strategy against the destruction of TJs and the attendant worsening of AKI due to periodontitis.ConclusionsOur study enhances the understanding of the interplay between periodontitis and AKI, highlighting the harmful impact of P. gingivalis in AKI.