title: Proteinuria is a simple sign of systemic inflammation that leads to a poor prognosis in individuals affected with non-Hodgkin lymphoma.
abstract: BACKGROUND
  The clinical significance of proteinuria has not been fully understood among patients who are affected with non-Hodgkin lymphoma (NHL).
  
  
  METHODS
  A 1-year prospective cohort study was conducted to ascertain the association between proteinuria and mortality in 46 hospitalized NHL patients. Proteinuria was defined as persistent dipstick test >= 1+, and the urinary protein creatinine ratio (UPCR),as a quantitative index of protein excretion, was measured simultaneously. A multivariable linear regression model was constructed to determine factors associated with UPCR. Statistical associations between proteinuria and time to mortality were analyzed using the Kaplan-Meier method and multivariable proportional hazards regression analysis, adjusted for covariates including disease severity, renal function, and serum interleukin-6(IL-6) concentration.
  
  
  RESULTS
  The prevalence of proteinuria was 15.2% in the NHL patients. UPCR was significantly associated with the serum IL-6 level (standardized beta = 0.360, p = 0.0440). The cumulative mortality was significantly higher in proteinuric patients than in non-proteinuric patients, with a graded relationship between the severity of UPCR and mortality. The mortality risk increased with increasing UPCR grade: the hazard ratio (95% confidence interval) was 4.90 (1.29 - 32.3) for UPCR 30 - 300 mg/gand 17.8 (2.84 - 150) for UPCR > 300 mg/g, respectively, when UPCR < 30 mg/g was set as the reference.
  
  
  CONCLUSIONS
  Proteinuria is a simple sign of coexisting systemic inflammation due to NHL and a harbinger of a poor prognosis.
authors.forename: Masaki
authors.initials: M
authors.lastname: Hara
authors.forename: Minoru
authors.initials: M
authors.lastname: Ando
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Maeda
authors.forename: Ken
authors.initials: K
authors.lastname: Tsuchiya
authors.forename: Kosaku
authors.initials: K
authors.lastname: Nitta
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000652:urine; D016009:Chi-Square Distribution; D003404:Creatinine / Q000652:urine; D005260:Female; D006760:Hospitalization; D006801:Humans; D007249:Inflammation / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D018836:Inflammation Mediators / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D007564:Japan; D053208:Kaplan-Meier Estimate; D016014:Linear Models; D008228:Lymphoma, Non-Hodgkin / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011507:Proteinuria / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
chemical_list: D000970:Antineoplastic Agents; D015415:Biomarkers; C508600:IL6 protein, human; D018836:Inflammation Mediators; D015850:Interleukin-6; D003404:Creatinine