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2016 ; 6
(ä): 26539
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Proteinuria as a Therapeutic Target in Advanced Chronic Kidney Disease: a
Retrospective Multicenter Cohort Study
#MMPMID27198863
Chen CH
; Wu HY
; Wang CL
; Yang FJ
; Wu PC
; Hung SC
; Kan WC
; Yang CW
; Chiang CK
; Huang JW
; Hung KY
Sci Rep
2016[May]; 6
(ä): 26539
PMID27198863
show ga
Current evidence of proteinuria reduction as a surrogate target in advanced
chronic kidney disease (CKD) is incomplete due to lack of patient-pooled
database. We retrospectively studied a multicenter cohort of 1891 patients who
were enrolled in the nationwide multidisciplinary pre-end stage renal disease
care program with a baseline glomerular filtration rate (GFR)
<45?mL/min/1.73?m(2) and followed longitudinally to investigate the effect of the
change in proteinuria on renal death (defined as composite of dialysis and death
occurring before initiation of dialysis). The group with a change in proteinuria
?0.30?g/g (n?=?1261) had lower cumulative probabilities of renal death
(p?0.001). In a linear regression model, a higher baseline proteinuria and a
greater increase in proteinuria were associated with faster annual GFR decline.
Cox's analysis showed that every 1 unit increase in natural log(baseline
proteinuria, 10?g/g) and every 0.1?g/g increase in the change in proteinuria
resulted in 67% (HR?=?1.67, 95% CI: 1.46-1.91) and 1% (HR?=?1.01, 95% CI:
1.01-1.01) greater risk of renal death respectively after adjusting for the
effects of the other covariates. Our study provided a patient-based evidence to
support proteinuria as a therapeutic target in advanced CKD.