Does Urinary Protein Excretion and Hypertension Significantly Correlate with Progression to End Stage Renal Failure?
Journal Title: International Journal of Medical Research Professionals - Year 2017, Vol 3, Issue 4
Abstract
Aims: To identify the prognostic factors possibly related to end-stage renal failure development. Materials & Methods: The prognostic factors affecting chronic renal failure progression were analysed in 456 patients aimed at verifying the role of protein restriction in slowing down or halting the progression of chronic renal failure. 311 patients completed the 24-month follow-up foreseen by the protocol and 69 reached an end-point. Using the Cox proportional hazard regression model, using a stepwise procedure in order to select only those factors, which are significantly associated with survival, made an inductive analysis on patient survival. For each individual risk factor, a univariate descriptive analysis of survival was performed using the Kaplan-Meier technique. Results: Underlying nephropathy, baseline plasma creatinine, proteinuria, and plasma calcium were all shown to be related to end-stage renal failure onset. Hypertensive patients (mean blood pressure > 107 mmHg) had a worst cumulative renal survival but the degree of proteinuria was even more important as a prognostic factor of renal death than hypertension. The cumulative renal survival of patients whose proteinuria decreased during the trial follow-up was better than those of patients without changes. However, the interaction between baseline lying mean blood pressure and proteinuria was not significant. Conclusions: Only primary renal disease and proteinuria were related to renal survival, being baseline plasma creatinine confounding factor. By blocking the possible causal role of proteinuria and hypertension, end-stage renal failure could be prevented in a significant percentage of patients.
Authors and Affiliations
Vikash Khandelia, Nilesh Jain, Ankur Jhanwar, Pavan Kumar Pyarsabadi, Saurabh Chittora, Umashankar Nama
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