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

Autor: Kang Seok Hui, Cho Kyu Hyang, Park Jong Won, Yoon Kyung Woo, Do Jun Young
Jazyk: angličtina
Rok vydání: 2012
Předmět:
Zdroj: BMC Nephrology, Vol 13, Iss 1, p 171 (2012)
Druh dokumentu: article
ISSN: 1471-2369
DOI: 10.1186/1471-2369-13-171
Popis: 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; 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.
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