Proteinuria and blood pressure as causal components of progression to end-stage renal failure

F. Locatelli, D. Marcelli, M. Comelli, D. Alberti, G. Graziani, G. Buccianti, B. Redaelli, A. Giangrande, P. Marai, F. Tentori, D. Marcelli, R. Ponti, F. Locatelli, G. Ambroso, A. Aroldi, C. Ponticelli, M. G. Gentile, M. G. Manna, G. D'Amico, D. CresseriM. Lorenz, G. Buccianti, M. R. Viganò, G. Bonoldi, B. Redaelli, A. Castighoni, A. Giangrande, D. Donati, L. Gastaldi, G. Como, R. Silenzio, D. Brancaccio, E. Gotti, G. Mecca, B. Dozio, G. Cairo, F. Conte, M. Meroni, A. Sessa, L. Picardi, G. Villa, A. Salvadeo, P. Cosci, M. Surian, C. Depetri, M. Mileti, O. Bracchi, B. Giraldi, C. Grassi, E. Reina, U. Malcangi, A. Ramello, M. Baruffaldi, C. Baroni, G. E. Guida, G. Verzetti, A. Costantino, F. Vallino, S. Bassi, P. Poiatti, A. Castellani, G. Gaiani, E. Lusvarghi, D. Alberti, B. M. Francucci, G. Battiros

Research output: Contribution to journalArticle

Abstract

Aims. To identify the prognostic factors possibly related to end-stage renal failure development. Subjects and methods. The prognostic factors affecting chronic renal failure progression were analysed in 456 patients who had participated in a formal, multicentre, prospective randomized trial aimed at verifying the role of protein restriction in slowing down or halting the progression of chronic renal failure. The 24-month follow-up foreseen by the protocol was completed by 311 patients and 69 reached an end-point. An inductive analysis on patient survival was made by using the Cox proportional hazard regression model, using a stepwise procedure in order to select only those factors which are significantly associated with 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.

Original languageEnglish
Pages (from-to)461-467
Number of pages7
JournalNephrology Dialysis Transplantation
Volume11
Issue number3
Publication statusPublished - Mar 1996

Fingerprint

Proteinuria
Chronic Kidney Failure
Blood Pressure
Kidney
Creatinine
Renal Hypertension
Survival
Survival Analysis
Proportional Hazards Models
Hypertension
Calcium
Proteins

Keywords

  • Blood pressure
  • End-stage renal failure
  • Hypertension
  • Multicentre
  • Prognostic factors
  • Prospective randomized trial
  • Proteinuria

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

Cite this

Locatelli, F., Marcelli, D., Comelli, M., Alberti, D., Graziani, G., Buccianti, G., ... Battiros, G. (1996). Proteinuria and blood pressure as causal components of progression to end-stage renal failure. Nephrology Dialysis Transplantation, 11(3), 461-467.

Proteinuria and blood pressure as causal components of progression to end-stage renal failure. / Locatelli, F.; Marcelli, D.; Comelli, M.; Alberti, D.; Graziani, G.; Buccianti, G.; Redaelli, B.; Giangrande, A.; Marai, P.; Tentori, F.; Marcelli, D.; Ponti, R.; Locatelli, F.; Ambroso, G.; Aroldi, A.; Ponticelli, C.; Gentile, M. G.; Manna, M. G.; D'Amico, G.; Cresseri, D.; Lorenz, M.; Buccianti, G.; Viganò, M. R.; Bonoldi, G.; Redaelli, B.; Castighoni, A.; Giangrande, A.; Donati, D.; Gastaldi, L.; Como, G.; Silenzio, R.; Brancaccio, D.; Gotti, E.; Mecca, G.; Dozio, B.; Cairo, G.; Conte, F.; Meroni, M.; Sessa, A.; Picardi, L.; Villa, G.; Salvadeo, A.; Cosci, P.; Surian, M.; Depetri, C.; Mileti, M.; Bracchi, O.; Giraldi, B.; Grassi, C.; Reina, E.; Malcangi, U.; Ramello, A.; Baruffaldi, M.; Baroni, C.; Guida, G. E.; Verzetti, G.; Costantino, A.; Vallino, F.; Bassi, S.; Poiatti, P.; Castellani, A.; Gaiani, G.; Lusvarghi, E.; Alberti, D.; Francucci, B. M.; Battiros, G.

In: Nephrology Dialysis Transplantation, Vol. 11, No. 3, 03.1996, p. 461-467.

Research output: Contribution to journalArticle

Locatelli, F, Marcelli, D, Comelli, M, Alberti, D, Graziani, G, Buccianti, G, Redaelli, B, Giangrande, A, Marai, P, Tentori, F, Marcelli, D, Ponti, R, Locatelli, F, Ambroso, G, Aroldi, A, Ponticelli, C, Gentile, MG, Manna, MG, D'Amico, G, Cresseri, D, Lorenz, M, Buccianti, G, Viganò, MR, Bonoldi, G, Redaelli, B, Castighoni, A, Giangrande, A, Donati, D, Gastaldi, L, Como, G, Silenzio, R, Brancaccio, D, Gotti, E, Mecca, G, Dozio, B, Cairo, G, Conte, F, Meroni, M, Sessa, A, Picardi, L, Villa, G, Salvadeo, A, Cosci, P, Surian, M, Depetri, C, Mileti, M, Bracchi, O, Giraldi, B, Grassi, C, Reina, E, Malcangi, U, Ramello, A, Baruffaldi, M, Baroni, C, Guida, GE, Verzetti, G, Costantino, A, Vallino, F, Bassi, S, Poiatti, P, Castellani, A, Gaiani, G, Lusvarghi, E, Alberti, D, Francucci, BM & Battiros, G 1996, 'Proteinuria and blood pressure as causal components of progression to end-stage renal failure', Nephrology Dialysis Transplantation, vol. 11, no. 3, pp. 461-467.
Locatelli F, Marcelli D, Comelli M, Alberti D, Graziani G, Buccianti G et al. Proteinuria and blood pressure as causal components of progression to end-stage renal failure. Nephrology Dialysis Transplantation. 1996 Mar;11(3):461-467.
Locatelli, F. ; Marcelli, D. ; Comelli, M. ; Alberti, D. ; Graziani, G. ; Buccianti, G. ; Redaelli, B. ; Giangrande, A. ; Marai, P. ; Tentori, F. ; Marcelli, D. ; Ponti, R. ; Locatelli, F. ; Ambroso, G. ; Aroldi, A. ; Ponticelli, C. ; Gentile, M. G. ; Manna, M. G. ; D'Amico, G. ; Cresseri, D. ; Lorenz, M. ; Buccianti, G. ; Viganò, M. R. ; Bonoldi, G. ; Redaelli, B. ; Castighoni, A. ; Giangrande, A. ; Donati, D. ; Gastaldi, L. ; Como, G. ; Silenzio, R. ; Brancaccio, D. ; Gotti, E. ; Mecca, G. ; Dozio, B. ; Cairo, G. ; Conte, F. ; Meroni, M. ; Sessa, A. ; Picardi, L. ; Villa, G. ; Salvadeo, A. ; Cosci, P. ; Surian, M. ; Depetri, C. ; Mileti, M. ; Bracchi, O. ; Giraldi, B. ; Grassi, C. ; Reina, E. ; Malcangi, U. ; Ramello, A. ; Baruffaldi, M. ; Baroni, C. ; Guida, G. E. ; Verzetti, G. ; Costantino, A. ; Vallino, F. ; Bassi, S. ; Poiatti, P. ; Castellani, A. ; Gaiani, G. ; Lusvarghi, E. ; Alberti, D. ; Francucci, B. M. ; Battiros, G. / Proteinuria and blood pressure as causal components of progression to end-stage renal failure. In: Nephrology Dialysis Transplantation. 1996 ; Vol. 11, No. 3. pp. 461-467.
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abstract = "Aims. To identify the prognostic factors possibly related to end-stage renal failure development. Subjects and methods. The prognostic factors affecting chronic renal failure progression were analysed in 456 patients who had participated in a formal, multicentre, prospective randomized trial aimed at verifying the role of protein restriction in slowing down or halting the progression of chronic renal failure. The 24-month follow-up foreseen by the protocol was completed by 311 patients and 69 reached an end-point. An inductive analysis on patient survival was made by using the Cox proportional hazard regression model, using a stepwise procedure in order to select only those factors which are significantly associated with 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.",
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TY - JOUR

T1 - Proteinuria and blood pressure as causal components of progression to end-stage renal failure

AU - Locatelli, F.

AU - Marcelli, D.

AU - Comelli, M.

AU - Alberti, D.

AU - Graziani, G.

AU - Buccianti, G.

AU - Redaelli, B.

AU - Giangrande, A.

AU - Marai, P.

AU - Tentori, F.

AU - Marcelli, D.

AU - Ponti, R.

AU - Locatelli, F.

AU - Ambroso, G.

AU - Aroldi, A.

AU - Ponticelli, C.

AU - Gentile, M. G.

AU - Manna, M. G.

AU - D'Amico, G.

AU - Cresseri, D.

AU - Lorenz, M.

AU - Buccianti, G.

AU - Viganò, M. R.

AU - Bonoldi, G.

AU - Redaelli, B.

AU - Castighoni, A.

AU - Giangrande, A.

AU - Donati, D.

AU - Gastaldi, L.

AU - Como, G.

AU - Silenzio, R.

AU - Brancaccio, D.

AU - Gotti, E.

AU - Mecca, G.

AU - Dozio, B.

AU - Cairo, G.

AU - Conte, F.

AU - Meroni, M.

AU - Sessa, A.

AU - Picardi, L.

AU - Villa, G.

AU - Salvadeo, A.

AU - Cosci, P.

AU - Surian, M.

AU - Depetri, C.

AU - Mileti, M.

AU - Bracchi, O.

AU - Giraldi, B.

AU - Grassi, C.

AU - Reina, E.

AU - Malcangi, U.

AU - Ramello, A.

AU - Baruffaldi, M.

AU - Baroni, C.

AU - Guida, G. E.

AU - Verzetti, G.

AU - Costantino, A.

AU - Vallino, F.

AU - Bassi, S.

AU - Poiatti, P.

AU - Castellani, A.

AU - Gaiani, G.

AU - Lusvarghi, E.

AU - Alberti, D.

AU - Francucci, B. M.

AU - Battiros, G.

PY - 1996/3

Y1 - 1996/3

N2 - Aims. To identify the prognostic factors possibly related to end-stage renal failure development. Subjects and methods. The prognostic factors affecting chronic renal failure progression were analysed in 456 patients who had participated in a formal, multicentre, prospective randomized trial aimed at verifying the role of protein restriction in slowing down or halting the progression of chronic renal failure. The 24-month follow-up foreseen by the protocol was completed by 311 patients and 69 reached an end-point. An inductive analysis on patient survival was made by using the Cox proportional hazard regression model, using a stepwise procedure in order to select only those factors which are significantly associated with 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.

AB - Aims. To identify the prognostic factors possibly related to end-stage renal failure development. Subjects and methods. The prognostic factors affecting chronic renal failure progression were analysed in 456 patients who had participated in a formal, multicentre, prospective randomized trial aimed at verifying the role of protein restriction in slowing down or halting the progression of chronic renal failure. The 24-month follow-up foreseen by the protocol was completed by 311 patients and 69 reached an end-point. An inductive analysis on patient survival was made by using the Cox proportional hazard regression model, using a stepwise procedure in order to select only those factors which are significantly associated with 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.

KW - Blood pressure

KW - End-stage renal failure

KW - Hypertension

KW - Multicentre

KW - Prognostic factors

KW - Prospective randomized trial

KW - Proteinuria

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