Prognosis of chronic kidney disease with normal-range proteinuria: The CKD-ROUTE study

Background: Although lower estimated glomerular filtration rate (eGFR) and higher proteinuria are high risks for mortality and kidney outcomes, the prognosis of chronic kidney disease (CKD) in patients with normal-range proteinuria remains unclear.
Methods: In this prospective cohort study, 1138 newly visiting stage G2-G5 CKD patients were stratified into normal-range and abnormal-range proteinuria groups. Study endpoints were CKD progression (>50% eGFR loss or initiation of dialysis), cardiovascular events, and all-cause death.
Results: In total, 927 patients who were followed for >6 months were included in the analysis. The mean age was 67 years, and 70.2% were male. During a median follow-up of 35 months, CKD progression, cardiovascular events, and mortality were observed in 223, 110, and 55 patients, respectively. Patients with normal-range proteinuria had a significantly lower risk for CKD progression (hazard ratio, 0.20; 95% confidence interval, 0.10-0.38) than those with ...

研究背景：尽管低估算肾小球滤过率 (estimated glomerular filtration rate, eGFR) 与高水平蛋白尿 (proteinuria) 是死亡及肾脏不良结局的高危因素，但蛋白尿处于正常范围的慢性肾脏病 (chronic kidney disease, CKD) 患者的预后仍未明确。研究方法：本前瞻性队列研究纳入1138例初诊G2~G5期慢性肾脏病患者，按蛋白尿水平分为正常范围组与异常范围组。本研究的终点事件包括慢性肾脏病进展（估算肾小球滤过率下降＞50%或启动透析治疗）、心血管事件及全因死亡。研究结果：最终共927例随访时长超过6个月的患者纳入分析。患者平均年龄为67岁，男性占比70.2%。中位随访时长为35个月，期间分别有223例、110例及55例患者出现慢性肾脏病进展、心血管事件及全因死亡。与蛋白尿异常范围组患者相比，蛋白尿正常范围组患者的慢性肾脏病进展风险显著降低（风险比 (hazard ratio)：0.20；95%置信区间 (confidence interval)：0.10~0.38）……