Prognostic indicators in patients presenting with the nephrotic syndrome

Abstract

Clinical data from 246 patients presenting with a nephrotic syndrome and biopsy-proven glomerular disorder were analyzed, using statistical survival techniques, to determine which of several variables (sex, age, plasma creatinine, diastolic blood pressure and 24-hour urinary protein loss) were associated with subsequent end-stage renal failure. The best prediction of outcome could be made at one year (N = 121); then plasma creatinine (P less than 0.001) and heavy proteinuria (P = 0.049) were the best determinants. For a given plasma creatinine level, heavy urinary protein was associated with a worse outcome. The incidence of end-stage renal failure was greatest three to four years from the date edema first developed. Plasma creatinine and urinary protein values, collected four-monthly throughout the study period, were analyzed as time-dependent covariates. A relationship was found between the prevailing risk of renal failure and earlier heavy proteinuria (P less than 0.001). Spontaneous complete remission of proteinuria was associated with a highly favorable outcome (P = 0.001) and normal, or impaired but stable, renal function.

Dietary Protein Restriction for Retardation of Progression of Chronic Renal Failure: Yes or No?

“…Nevertheless, there was a significant reduction in the number of patients having a 50% reduction in creatinine clearance over time in the low protein diet group (28.6%) compared to the control diet group (40%; p =0.038). In addition the initial level of proteinuria was shown to be an independent risk factor for progression of renal failure, as also reported by other investigators (22,23).…”

Effect of echinacoside on kidney fibrosis by inhibition of TGF-β1/Smads signaling pathway in the db/db mice model of diabetic nephropathy

“…As is well known, the emergence of urinary microalbumin is a necessary indicator for the diagnosis of DN, and urinary albumin increase is an important indicator of the deterioration of DN. 22 Studies have shown that in patients with type 2 diabetes, 24-hour urinary protein (urinary albumin excretion rate) ≥30 mg/24 hours increased the risk of cardiovascular events, DN, and death by 2.20 times, 6.76 times, and 2.47 times. 23 Therefore, for the treatment of DN, it is important to reduce urinary protein excretion.…”

Effect of Gender on the Progression of Nondiabetic Renal Disease

“…Meta-analysis using the fixed-effects model was repeated using four studies (7,10,12,13) that contained 1664 patients, after exclusion of four studies that used an outcome measure other than ESRD requiring renal replacement therapy or a decline in isotopically determined GFR. Excluded studies used a rise in serum creatinine (n ϭ 3) or a decline in creatinine clearance (n ϭ 1) as an outcome measure.…”