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Results

Median nPCRs with and without accounting for renal urea clearance at baseline were 0.94 and 0.78 g/kg per day, respectively (median within-patient difference, 0.14 [interquartile range, 0.07–0.23] g/kg per day). During a median follow-up period of 1.4 years, 8481 deaths were observed. Baseline renal urea clearance–corrected nPCR was associated with higher serum albumin and lower mortality in the fully adjusted model (P trend< 0.001). Among 13,895 patients with available data, greater rise in renal urea clearance–corrected nPCR during the first 6 months was also associated with attaining high serum albumin (≥ 3.8 g/dl) and lower mortality (P trend< 0.001); compared with the reference group (a change of 0.1–0.2 g/kg per day), odds and hazard ratios were 0.53 (95% confidence interval, 0.44 to 0.63) and 1.32 (95% confidence interval, 1.14 to 1.54), respectively, among patients with a change of<− 0 …