Retarding progression of chronic renal disease: The neglected issue of residual proteinuria
Retarding progression of chronic renal disease: The neglected issue of residual proteinuria
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DOI：
10.1046/j.1523-1755.2003.00033.x
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发表时间：
2003-06-01
影响因子：
19.6
通讯作者：
Remuzzi, G
中科院分区：
文献类型：
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作者：
Ruggenenti, P;Perna, A;Remuzzi, G
背景。蛋白尿的早期变化独立预测长期肾小球滤过率 (GFR) 下降 (DeltaGFR) 的发现将强调蛋白尿是慢性肾病进展的主要决定因素。方法。我们研究了参加雷米普利肾病疗效 (REIN) 的 273 名蛋白尿慢性肾病患者中，蛋白尿（根据 GFR 的伴随变化进行调整）和 3 个月时残留蛋白尿的百分比变化（3 个月与基线相比）是否可以预测 DeltaGFR [在中位（智商范围）随访 31.3（24.5 至 50.3）个月内]。 研究.结果.短期变化和残留蛋白尿（r=-0.23，P=0.0001）与 DeltaGFR 显着相关，并且在多变量分析中独立预测 DeltaGFR（分别为 beta=-0.23，P=0.0002；beta=-0.21，P=0.0004）。对于残留蛋白尿水平相当的情况，短期降低幅度较大的患者 DeltaGFR 较慢（-0.28+/-0.04 mL/min/1.73 m(2)/vs.-0.53+/-0.07 mL/min/1.73 m(2)/月，P=0.04）。在雷米普利和常规治疗中，蛋白尿的镜面短期变化（-18.2+/-3.5% vs. 24.2+/-6.7%，P
Background. Findings that early changes in proteinuria independently predict long-term glomular filtration rate (GFR) decline (DeltaGFR) would highlight proteinuria as a major determinant of progression in chronic renal disease.Methods. We investigated whether percent changes (3 months vs. baseline) in proteinuria (adjusted for concomitant changes in GFR) and residual proteinuria at 3 months, predicted DeltaGFR [over a median (IQ range) follow up of 31.3 (24.5 to 50.3) months] in 273 patients with proteinuric chronic nephropathies enrolled in the Ramipril Efficacy In Nephropathy (REIN) study.Results. Short-term changes and residual proteinuria (r=-0.23, P=0.0001 for both) significantly correlated with DeltaGFR and, at multivariate analyses, independently predicted DeltaGFR (beta=-0.23, P=0.0002; beta=-0.21, P=0.0004, respectively). For comparable levels of residual proteinuria, patients with greater short-term reduction had slower DeltaGFR (-0.28+/-0.04 mL/min/1.73 m(2)/vs. -0.53+/-0.07 mL/min/1.73 m(2)/month, P=0.04). On ramipril and conventional treatment, specular short-term changes in proteinuria (-18.2+/-3.5% vs. 24.2+/-6.7%, P