Chen C.-H.Wu H.-Y.Wang C.-L.FENG-JUNG YANGWu P.-C.Hung S.-C.Kan W.-C.CHUNG WEI YANGCHIH-KANG CHIANGJENQ-WEN HUANGKUAN-YU HUNG2020-12-242020-12-2420162045-2322https://www.scopus.com/inward/record.uri?eid=2-s2.0-84970028286&doi=10.1038%2fsrep26539&partnerID=40&md5=3118eb831b850075529ba9bcd42d426bhttps://scholars.lib.ntu.edu.tw/handle/123456789/531763Current evidence of proteinuria reduction as a surrogate target in advanced chronic kidney disease (CKD) is incomplete due to lack of patient-pooled database. We retrospectively studied a multicenter cohort of 1891 patients who were enrolled in the nationwide multidisciplinary pre-end stage renal disease care program with a baseline glomerular filtration rate (GFR) <45 mLmin1.73 m 2 and followed longitudinally to investigate the effect of the change in proteinuria on renal death (defined as composite of dialysis and death occurring before initiation of dialysis). The group with a change in proteinuria ?0.30 gg (n = 1261) had lower cumulative probabilities of renal death (p < 0.001). In a linear regression model, a higher baseline proteinuria and a greater increase in proteinuria were associated with faster annual GFR decline. Cox? € s analysis showed that every 1 unit increase in natural log(baseline proteinuria, 10 gg) and every 0.1 gg increase in the change in proteinuria resulted in 67% (HR = 1.67, 95% CI: 1.46-1.91) and 1% (HR = 1.01, 95% CI: 1.01-1.01) greater risk of renal death respectively after adjusting for the effects of the other covariates. Our study provided a patient-based evidence to support proteinuria as a therapeutic target in advanced CKD.[SDGs]SDG3creatinine; aged; chronic kidney failure; clinical trial; complication; disease exacerbation; evidence based medicine; female; glomerulus filtration rate; human; longitudinal study; male; metabolism; middle aged; multicenter study; pathophysiology; proteinuria; retrospective study; risk factor; statistical model; Taiwan; urine; very elderly; Aged; Aged, 80 and over; Creatinine; Disease Progression; Evidence-Based Medicine; Female; Glomerular Filtration Rate; Humans; Linear Models; Longitudinal Studies; Male; Middle Aged; Proteinuria; Renal Insufficiency, Chronic; Retrospective Studies; Risk Factors; Taiwanjournal article10.1038/srep26539271988632-s2.0-84970028286