title: 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.
  
  
  CONCLUSIONS
  The attenuation of the nephrotic proteinuria, along with the RRF decline, was associated with the improvement of the malnutrition.
authors.affiliation: Department of Internal Medicine, Division of Nephrology, Yeungnam University Hospital, 317-1 Daemyung-Dong, Nam-Ku 705-717, Daegu, Korea.
authors.forename: Seok Hui
authors.initials: SH
authors.lastname: Kang
authors.forename: Kyu Hyang
authors.initials: KH
authors.lastname: Cho
authors.forename: Jong Won
authors.initials: JW
authors.lastname: Park
authors.forename: Kyung Woo
authors.initials: KW
authors.lastname: Yoon
authors.forename: Jun Young
authors.initials: JY
authors.lastname: Do
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects; D011507:Proteinuria / Q000453:epidemiology* / Q000628:therapy*; D016896:Treatment Outcome