title: Proteinuria as a risk factor for decline in residual renal function in non-diabetic peritoneal dialysis patients.
abstract: BACKGROUND
  Preservation of residual renal function (RRF) is a major issue for patients on peritoneal dialysis (PD). Whether proteinuria is associated with a decline in RRF in patients on PD remains unclear.
  
  
  METHODS
  We reviewed the medical records at the Yeungnam University Hospital in Korea and identified patients who started PD between June 1995 and August 2011. A total of 147 non-diabetic patients were enrolled in the study. The patients were divided into 3 groups with respect to the tertile of initial proteinuria level: Low (n = 49; <320 mg/day), Middle (n = 49; 320-822 mg/day), and High groups (n = 49; >822 mg/day).
  
  
  RESULTS
  The mean patient age was 50.2 ± 15.0 years in the Low tertile, 50.2 ± 15.4 years in the Middle tertile, and 49.0 ± 15.1 years in the High tertile. Decline in RRF during follow-up period was greater in the High tertile than that in the other tertiles (P = 0.001). The proportion of patients with RRF >50% of baseline at 24 months after the initiation of PD was 83% in the Low tertile, 66% in the Middle tertile, and 40% in the High tertile (P < 0.001). The multivariate analysis after adjusting for initial RRF, age, gender, underlying disease of end-stage renal disease except diabetes mellitus, PD modality, use of icodextrin, PD-associated peritonitis, and tertile of the initial proteinuria level revealed that High tertile of the initial proteinuria level was associated with a decline in RRF (hazard ratios: 2.442 for the Middle tertile, P = 0.007 ; 3.713 for the Low tertile, P < 0.001).
  
  
  CONCLUSIONS
  The present study demonstrates that proteinuria may be is associated with a rapid decline in RRF in non-diabetic patients on PD, although the potential role of additional factors should be further investigated in prospective studies.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Yeungnam University Hospital, Daegu 705-717, 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: D000367:Age Factors; D000368:Aged; D001002:Anuria; D044466:Asian People; D005260:Female; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D011446:Prospective Studies; D011507:Proteinuria / Q000150:complications* / Q000453:epidemiology; D012307:Risk Factors; D012737:Sex Factors; D016019:Survival Analysis