Impact of heavy proteinuria on clinical outcomes in patients on incident peritoneal dialysis.

Abstract

BACKGROUND:

There are few reports on the nutritional status changes and residual renal function (RRF) according to proteinuria levels in patients on peritoneal dialysis (PD).

METHODS:

A total of 388 patients on PD were enrolled. The patients were divided into 3 groups with respect to initial proteinuria: the A (n = 119; <500 mg/day), B (n = 218; 500-3,500 mg/day), and C groups (n = 51; >3,500 mg/day).

RESULTS:

The patients with higher proteinuria levels had a higher incidence of male sex, diabetes mellitus, and icodextrin use than those with lower proteinuria levels. Although initial peritoneal albumin loss in C group was lower than that detected in the other groups, no significant difference was observed in peritoneal albumin loss among the 3 groups at the end of follow-up period. At the time of PD initiation, the Geriatric nutritional risk index (GNRI) was lower in the C group than in the other 2 groups. However, at the end of the follow-up period, there was no significant difference in GNRI between the 3 groups. The GNRI increased, and the proteinuria level or RRF decreased more in the C group than in the other 2 groups. There were no significant differences in lean mass index or fat mass index change from the time of PD initiation to the end of the follow-up period. However, fat mass index and nPNA showed greater increases in the C group. The multivariate analysis revealed that proteinuria was negatively correlated with GNRI at the time of PD initiation and at the end of the follow-up period. The initial RRF and proteinuria were negatively correlated with the RRF decline during the follow-up.

CONCLUSION:

The attenuation of the nephrotic proteinuria, along with the RRF decline, was associated with the improvement of the malnutrition.

• Authors: Seok Hui Kang, Kyu Hyang Cho, Jong Won Park, Kyung Woo Yoon, Jun Young Do
• Journal: BMC nephrology (BMC Nephrol) Vol. 13 Pg. 171 (Dec 17 2012) ISSN: 1471-2369 [Electronic] England
• PMID: 23245677 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Female
• Follow-Up Studies
• Humans
• Incidence
• Kidney Failure, Chronic (epidemiology, therapy)
• Male
• Middle Aged
• Peritoneal Dialysis (adverse effects)
• Proteinuria (epidemiology, therapy)
• Treatment Outcome