Objective: Proteinuria reduction has been extensively studied in patients with chronic kidney disease. However, there are few studies addressing the effects of diuretic treatment on proteinuria. We aimed to evaluate the effects of strict volume control achieved by the diuretic therapy on proteinuria among patients with proteinuric kidney disease and concomitant hypervolemia as measured by bio-impedance analysis (BIA).
Materials and Methods: Patients having proteinuria on spot urine analysis, overhydration (OH) value of >0 in BIA and a treatment plan including diuretics were included in this prospective study. The follow-up period was defined as the time from the addition of diuretic therapy due to hypervolemic status to the achievement of normovolemia in each patient.
Results: We evaluated 46 hypervolemic patients, of which 25 (54.3%) were men and 39 (64%) were women, with a mean age of 56.85 ± 14.43 years (range 20 to 86 years). The median follow-up period was 12 days (min 5 - max 90). After diuretic treatment, there was a statistically significant decrease in systolic and diastolic blood pressure values (p <0.001, p <0.001, respectively). The protein excretion in spot urine was 6.3 (2.6-10.4) g before treatment. After volume control, proteinuria level significantly regressed and decreased to 1.5 (0.6-2.9) g (p <0.001). A statistically significant association was determined between the decrease in extracellular water and the decline in proteinuria levels (p = 0.035) in regression analysis.
Conclusion: Our findings revealed the association of volume control provided by the diuretic treatment with proteinuria reducing and blood pressure lowering effects.