title: Incidence and predictive value of proteinuria in community-acquired pneumonia.
abstract: OBJECTIVE
  The presence of baseline proteinuria predicts the outcome in patients with chronic kidney disease and in the general population, independent of renal function. However, the predictive value of proteinuria during an episode of acute illness has not been reported yet. Therefore, we investigated the incidence and predictive value of proteinuria in patients with community-acquired pneumonia.
  
  
  METHODS
  An analysis of prospectively collected data, obtained from patients >18 years of age, was performed. Patients were hospitalized with community-acquired pneumonia in two hospitals in the Netherlands and participated in two consecutive clinical trials. A total protein/creatinine (P/C) ratio was measured in a urine sample from the day of admission. Patients were categorized in quartiles of P/C ratio. Primary outcome was length of hospital stay.
  
  
  RESULTS
  198/319 patients (62%) had a P/C ratio >23 mg/mmol creatinine. In multivariate analysis, proteinuria turned out to be an independent predictor for length of stay and admission to the intensive care unit.
  
  
  CONCLUSIONS
  The incidence of proteinuria during pneumonia is high and proteinuria is an independent predictor for length of hospital stay and admission to the intensive care unit. Proteinuria is a cheap and easily accessible marker for outcome and might be used to assess the severity of pneumonia.
authors.affiliation: St. Antonius Hospital, Nieuwegein, The Netherlands. s.spoorenberg@antoniusziekenhuis.nl
authors.forename: Simone M C
authors.initials: SM
authors.lastname: Spoorenberg
authors.forename: Sabine C A
authors.initials: SC
authors.lastname: Meijvis
authors.forename: Gerjan
authors.initials: G
authors.lastname: Navis
authors.forename: Henk J
authors.initials: HJ
authors.lastname: Ruven
authors.forename: Douwe H
authors.initials: DH
authors.lastname: Biesma
authors.forename: Jan C
authors.initials: JC
authors.lastname: Grutters
authors.forename: Willem Jan W
authors.initials: WJ
authors.lastname: Bos
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015984:Causality; D017714:Community-Acquired Infections / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D015897:Comorbidity; D003422:Critical Care / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010343:Patient Admission / Q000706:statistics & numerical data*; D018410:Pneumonia, Bacterial / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D011379:Prognosis; D011507:Proteinuria / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D012307:Risk Factors