Effect of Proteinuria on Residual Renal Function in Peritoneal Dialysis Patients_West China Medical Journal

Authors：

 JINLi-zhu , CHENZe-jun ,  GONGRong , YANGBin , SHUYing , QUANDa-yong , TONGYu-na

Department of Nephrology, the Second Affiliated Hospital of Chongqing Medical University & the Third People's Hospital of Chengdu, Chengdu, Sichuan 610031, P. R. China;

Corresponding author：

GONGRong, Email: gongr2006@sina.com

Keywords：

Chronic kidney disease; Peritoneal dialysis; Proteinuria; Residual renal function; Affecting factors

DOI：

10.7507/1002-0179.20140667

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To observe whether proteinuria is relate to the decline of residual renal function (RRF) in peritoneal dialysis (PD) patients. Methods This is a prospective cohort study including 45 PD patients (underwent PD between January 2011 and January 2013) with a 12-month follow-up. All the patients were divided into 2 groups with respect to the initial proteinuria level: massive proteinuria group A (n=20) and non-massive proteinuria group B (n=25) at baseline. We established regression models to do univariate analysis and multivariate analysis of the relationship between the decline of RRF≥50% of baseline and the indices of age, sex, PD-associated peritonitis, baseliner residual glomerular filtration rate (rGFR), initial proteinuria, and use of ACEI/ARB. Results The primary outcome (RRF>50% of baseline) at 12 months was 65% in group A, and 80% in group B (P<0.05). Based both on the results of univariate and multivariate Cox regression analysis, non-massive proteinuria and higher rGFR at baseline were factors to protect RRF from decline (P<0.05). Conclusion The study demonstrates that massive proteinuria and lower rGFR at baseline may be associated with a rapid decline of RRF in PD patients. Treatment aimed at reducing albuminuria may lead to protect RRF and improve life quality of patients.

Citation： JINLi-zhu, CHENZe-jun, GONGRong, YANGBin, SHUYing, QUANDa-yong, TONGYu-na. Effect of Proteinuria on Residual Renal Function in Peritoneal Dialysis Patients. West China Medical Journal, 2014, 29(12): 2205-2208. doi: 10.7507/1002-0179.20140667 Copy

1.	Zhang L, Wang F, Wang L, et al. Prevalence of chronic kidney disease in China:a cross-sectional survey[J]. Lancet, 2012, 379(9818):815-822.
2.	Kang SH, Cho KH, Park JW, et al. Risk factors for mortality in stable peritoneal dialysis patients[J]. Ren Fail, 2012, 34(2):149-154.
3.	Tam P. Peritoneal dialysis and preservation of residual renal function[J]. Perit Dial Int, 2009, 29(Suppl 2):S108-S110.
4.	王丽妍, 张东亮, 刁宗礼, 等. 透析患者残余肾功能的保护[J]. 中国血液净化, 2012, 11(2):95-98.
5.	Abbate M, Zoja C, Remuzzi G. How does proteinuria cause progressive renal damage?[J]. J Am Soc Nephrol, 2006, 17(11):2974-2984.
6.	Singhal MK, Bhaskaran S, Vidgen E, et al. Rate of decline of residual renal function in patients on continuous peritoneal dialysis and factors affecting it[J]. Perit Dial Int, 2001, 20(4):429-438.
7.	陈香美. 中国腹膜透析技术发展现状与未来[J]. 中国实用内科杂志, 2013, 33(6):413-415.
8.	龚蓉, 陈泽君, 皮婧婧, 等. 三级医院与社区医院联合管理居家腹膜透析患者实践效果的初讨[J]. 华西医学, 2014, 29(5):831-834.
9.	Paniagua R, Amato D, Voneshi E, et al. Effects of increased peritoneal clearances on mortality rates in peritoneal dialysis:ADEMEX, a prospective, randomized, controlled trial[J]. J Am Soc Nephrol, 2002, 13(5):1307-1320.
10.	Bargman JM, Thorpe KE, Churchill DN, et al. Relative contribution of residual renal function and peritoneal clearance to adequacy of dialysis:a reanalysis of the CANUSA study[J]. J Am Soc Nephrol, 2001, 12(10):2158-2162.
11.	Moist LM, Port FK, Orzol SM, et al. Predictors of loss of residual renal function among new dialysis patients[J]. J Am Soc Nephrol, 2000, 11(3):556-564.
12.	Liao CT, Shiao CC, Huang JW, et al. Predictors of faster decline of residual renal function in Taiwanese peritoneal dialysis patients[J]. Perit Dial Int, 2008, 28(Suppl 3):S191-S195.
13.	Liu JH, Wang SM, Chen CC, et al. Relation of ankle-brachial index to the rate of decline of residual renal function in peritoneal dialysis patients[J]. Nephrology (Carlton), 2011, 16(2):187-193.
14.	Kolesnyk I, Noordzij M, Dekker FW, et al. Treatment with angiotensinⅡ inhibitors and residual renal function in peritoneal dialysis patients[J]. Perit Dial Int, 2011, 31(1):53-59.
15.	Reyes-Marín F, Calzada C, Ballesteros A, et al. Comparative study of enalapril vs. losartan on residual renal function preservation in automated peritoneal dialysis. A randomized controlled study[J]. Rev Invest Clin, 2012, 64(4):315-321.
16.	Akbari A, Knoll G, Ferguson D, et al. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in peritoneal dialysis:systematic review and meta-analysis of randomized controlled trials[J]. Perit Dial Int, 2009, 29(5):554-561.
17.	Ryckelynck JP, Goffin É, Verger C, et al. Maintaining residual renal function in patients on dialysis[J]. Nephrol Ther, 2013, 9(6):403-407.

1. Zhang L, Wang F, Wang L, et al. Prevalence of chronic kidney disease in China:a cross-sectional survey[J]. Lancet, 2012, 379(9818):815-822.
2. Kang SH, Cho KH, Park JW, et al. Risk factors for mortality in stable peritoneal dialysis patients[J]. Ren Fail, 2012, 34(2):149-154.
3. Tam P. Peritoneal dialysis and preservation of residual renal function[J]. Perit Dial Int, 2009, 29(Suppl 2):S108-S110.
4. 王丽妍, 张东亮, 刁宗礼, 等. 透析患者残余肾功能的保护[J]. 中国血液净化, 2012, 11(2):95-98.
5. Abbate M, Zoja C, Remuzzi G. How does proteinuria cause progressive renal damage?[J]. J Am Soc Nephrol, 2006, 17(11):2974-2984.
6. Singhal MK, Bhaskaran S, Vidgen E, et al. Rate of decline of residual renal function in patients on continuous peritoneal dialysis and factors affecting it[J]. Perit Dial Int, 2001, 20(4):429-438.
7. 陈香美. 中国腹膜透析技术发展现状与未来[J]. 中国实用内科杂志, 2013, 33(6):413-415.
8. 龚蓉, 陈泽君, 皮婧婧, 等. 三级医院与社区医院联合管理居家腹膜透析患者实践效果的初讨[J]. 华西医学, 2014, 29(5):831-834.
9. Paniagua R, Amato D, Voneshi E, et al. Effects of increased peritoneal clearances on mortality rates in peritoneal dialysis:ADEMEX, a prospective, randomized, controlled trial[J]. J Am Soc Nephrol, 2002, 13(5):1307-1320.
10. Bargman JM, Thorpe KE, Churchill DN, et al. Relative contribution of residual renal function and peritoneal clearance to adequacy of dialysis:a reanalysis of the CANUSA study[J]. J Am Soc Nephrol, 2001, 12(10):2158-2162.
11. Moist LM, Port FK, Orzol SM, et al. Predictors of loss of residual renal function among new dialysis patients[J]. J Am Soc Nephrol, 2000, 11(3):556-564.
12. Liao CT, Shiao CC, Huang JW, et al. Predictors of faster decline of residual renal function in Taiwanese peritoneal dialysis patients[J]. Perit Dial Int, 2008, 28(Suppl 3):S191-S195.
13. Liu JH, Wang SM, Chen CC, et al. Relation of ankle-brachial index to the rate of decline of residual renal function in peritoneal dialysis patients[J]. Nephrology (Carlton), 2011, 16(2):187-193.
14. Kolesnyk I, Noordzij M, Dekker FW, et al. Treatment with angiotensinⅡ inhibitors and residual renal function in peritoneal dialysis patients[J]. Perit Dial Int, 2011, 31(1):53-59.
15. Reyes-Marín F, Calzada C, Ballesteros A, et al. Comparative study of enalapril vs. losartan on residual renal function preservation in automated peritoneal dialysis. A randomized controlled study[J]. Rev Invest Clin, 2012, 64(4):315-321.
16. Akbari A, Knoll G, Ferguson D, et al. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in peritoneal dialysis:systematic review and meta-analysis of randomized controlled trials[J]. Perit Dial Int, 2009, 29(5):554-561.
17. Ryckelynck JP, Goffin É, Verger C, et al. Maintaining residual renal function in patients on dialysis[J]. Nephrol Ther, 2013, 9(6):403-407.

West China Medical Journal

Effect of Proteinuria on Residual Renal Function in Peritoneal Dialysis Patients

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