Proteinuria as a risk factor for decline in residual renal function in non-diabetic peritoneal dialysis patients.

Abstract

BACKGROUND:

Preservation of residual renal function (RRF) is a major issue for patients on peritoneal dialysis (PD). Whether proteinuria is associated with a decline in RRF in patients on PD remains unclear.

PATIENTS AND METHODS:

We reviewed the medical records at the Yeungnam University Hospital in Korea and identified patients who started PD between June 1995 and August 2011. A total of 147 non-diabetic patients were enrolled in the study. The patients were divided into 3 groups with respect to the tertile of initial proteinuria level: Low (n = 49; <320 mg/day), Middle (n = 49; 320-822 mg/day), and High groups (n = 49; >822 mg/day).

RESULTS:

The mean patient age was 50.2 ± 15.0 years in the Low tertile, 50.2 ± 15.4 years in the Middle tertile, and 49.0 ± 15.1 years in the High tertile. Decline in RRF during follow-up period was greater in the High tertile than that in the other tertiles (P = 0.001). The proportion of patients with RRF >50% of baseline at 24 months after the initiation of PD was 83% in the Low tertile, 66% in the Middle tertile, and 40% in the High tertile (P < 0.001). The multivariate analysis after adjusting for initial RRF, age, gender, underlying disease of end-stage renal disease except diabetes mellitus, PD modality, use of icodextrin, PD-associated peritonitis, and tertile of the initial proteinuria level revealed that High tertile of the initial proteinuria level was associated with a decline in RRF (hazard ratios: 2.442 for the Middle tertile, P = 0.007 ; 3.713 for the Low tertile, P < 0.001).

CONCLUSION:

The present study demonstrates that proteinuria may be is associated with a rapid decline in RRF in non-diabetic patients on PD, although the potential role of additional factors should be further investigated in prospective studies.

• Authors: Seok Hui Kang, Kyu Hyang Cho, Jong Won Park, Kyung Woo Yoon, Jun Young Do
• Journal: Kidney & blood pressure research (Kidney Blood Press Res) Vol. 37 Issue 2-3 Pg. 199-210 ( 2013) ISSN: 1423-0143 [Electronic] Switzerland
• PMID: 23736779 (Publication Type: Journal Article)
• Copyright: Copyright © 2013 S. Karger AG, Basel.

Topics

• Age Factors
• Aged
• Anuria
• Asian People
• Female
• Humans
• Kidney (physiopathology)
• Kidney Failure, Chronic (epidemiology, physiopathology, therapy)
• Kidney Function Tests
• Male
• Middle Aged
• Peritoneal Dialysis
• Prospective Studies
• Proteinuria (complications, epidemiology)
• Risk Factors
• Sex Factors
• Survival Analysis