Objective: To investigate whether chronic kidney disease (CKD) and proteinuria are associated with mortality rates in patients with Parkinson’s disease (PD), using data from a large nationwide cohort

Background: Various comorbidities contribute to mortality in patients with PD. Although growing evidence demonstrates that CKD increases the risk of developing PD, the effect of CKD on all-cause mortality remains unclear.

Method: We enrolled 59,293 patients aged ≥40 years with de novo PD between 2009 and 2015, using de-identified data from the National Health Insurance Service. Cox proportional hazards regression analysis using the presence of CKD or proteinuria as a predictor was performed to investigate the association between CKD, proteinuria, and mortality. For sensitivity analysis, the degree of eGFR or proteinuria were used as predictors in place of CKD/proteinuria.

Results: PD patients with CKD (hazard ratio [HR]=1.240, 95% confidence interval [CI] 1.190– 1.283) and proteinuria (HR=1.543, 95% CI 1.457 – 1.634) had a higher risk of mortality, even after controlling for confounding factors. The degree of kidney dysfunction (p < 0.001) and proteinuria (p < 0.001) were associated with an increased HR for mortality. Furthermore, female patients with CKD were more vulnerable to mortality than male patients (p for sex × CKD < 0.001); however, there was no sex-specific vulnerability of proteinuria to mortality (p for sex × proteinuria = 0.603).

Conclusion: CKD and proteinuria were associated with a higher all-cause mortality in patients with PD in a dose-dependent manner. Furthermore, these results highlight that strategies for controlling kidney function are necessary to reduce mortality in patients with PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/chronic-kidney-disease-proteinuria-and-mortality-risk-in-patients-with-parkinsons-disease-a-longitudinal-study/