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

Title
Impact of heavy proteinuria on clinical outcomes in patients on incident peritoneal dialysis
Author(s)
도준영강석휘[강석휘]조규향박종원윤경우
Keywords
RESIDUAL RENAL-FUNCTION; NUTRITIONAL RISK INDEX; ALBUMIN HOMEOSTASIS; DIETARY-PROTEIN; KIDNEY-DISEASE; ADEQUACY; PREDICTORS; DECLINE; HYPOALBUMINEMIA; AMINOGLYCOSIDES
Issue Date
201212
Publisher
BIOMED CENTRAL LTD
Citation
BMC NEPHROLOGY, v.13
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.
URI
http://hdl.handle.net/YU.REPOSITORY/26840http://dx.doi.org/10.1186/1471-2369-13-171
ISSN
1471-2369
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의과대학 > 내과학교실 > Articles
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