Baseline proteinuria level is associated with prognosis in idiopathic membranous nephropathy

Objectives: This study aimed to investigate the unique prognostic, clinical, and renal histopathological characteristics of patients with idiopathic membranous nephropathy (IMN) with different levels of proteinuria. Methods: This retrospective observational study included 190 IMN patients with low l...

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Main Authors: Xinxin Chen, Yu Chen, Xiaokai Ding, Ying Zhou, Yinqiu Lv, Duo Li, Bo Chen, Tianxin Chen, Chaosheng Chen
Format: Article
Language:English
Published: Taylor & Francis Group 2019-01-01
Series:Renal Failure
Subjects:
Online Access:http://dx.doi.org/10.1080/0886022X.2019.1605294
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author Xinxin Chen
Yu Chen
Xiaokai Ding
Ying Zhou
Yinqiu Lv
Duo Li
Bo Chen
Tianxin Chen
Chaosheng Chen
author_facet Xinxin Chen
Yu Chen
Xiaokai Ding
Ying Zhou
Yinqiu Lv
Duo Li
Bo Chen
Tianxin Chen
Chaosheng Chen
author_sort Xinxin Chen
collection DOAJ
description Objectives: This study aimed to investigate the unique prognostic, clinical, and renal histopathological characteristics of patients with idiopathic membranous nephropathy (IMN) with different levels of proteinuria. Methods: This retrospective observational study included 190 IMN patients with low levels of proteinuria (low group), 193 IMN patients with medium levels of proteinuria (medium group), and 123 IMN patients with high levels of proteinuria (high group) treated between September 2006 and November 2015. Prognostic and baseline clinical and histopathological data were compared among the three groups. Poor prognostic events included the occurrence of a persistent 50% reduction in estimated glomerular filtration rate (eGFR), end-stage renal disease, or all-cause mortality. Results: The severity of clinical symptoms and laboratory indices, such as blood pressure; extent of edema and hematuria; levels of fibrinogen, immunoglobulin (Ig)-G, complement (C)-4, total protein, albumin (ALB), and serum creatinine (SCr); and eGFR increased with increasing proteinuria (all p< .001). Based on renal histopathology, the extent of segmental sclerosis and balloon adhesion and renal interstitial lesion stage also increased in severity with increasing proteinuria (all p< .001). The Kaplan–Meier analysis showed that compared with patients with low and medium levels of proteinuria, patients with high levels of proteinuria had significantly lower cumulative poor event-free renal survival rates (p= .0039). Conclusions: Baseline proteinuria level is indicative of prognosis in IMN patients; the greater the extent of proteinuria is, the worse the prognosis.
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spelling doaj.art-c3a1e999fdc04013867b35535c06b9872022-12-21T21:27:54ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492019-01-0141136336910.1080/0886022X.2019.16052941605294Baseline proteinuria level is associated with prognosis in idiopathic membranous nephropathyXinxin Chen0Yu Chen1Xiaokai Ding2Ying Zhou3Yinqiu Lv4Duo Li5Bo Chen6Tianxin Chen7Chaosheng Chen8The First Affiliated Hospital of Wenzhou Medical UniversityZhejiang Chinese Medical University Affiliated Wenzhou Hospital of Traditional Chinese MedicineThe First Affiliated Hospital of Wenzhou Medical UniversityThe First Affiliated Hospital of Wenzhou Medical UniversityThe First Affiliated Hospital of Wenzhou Medical UniversityThe First Affiliated Hospital of Wenzhou Medical UniversityThe First Affiliated Hospital of Wenzhou Medical UniversityThe First Affiliated Hospital of Wenzhou Medical UniversityThe First Affiliated Hospital of Wenzhou Medical UniversityObjectives: This study aimed to investigate the unique prognostic, clinical, and renal histopathological characteristics of patients with idiopathic membranous nephropathy (IMN) with different levels of proteinuria. Methods: This retrospective observational study included 190 IMN patients with low levels of proteinuria (low group), 193 IMN patients with medium levels of proteinuria (medium group), and 123 IMN patients with high levels of proteinuria (high group) treated between September 2006 and November 2015. Prognostic and baseline clinical and histopathological data were compared among the three groups. Poor prognostic events included the occurrence of a persistent 50% reduction in estimated glomerular filtration rate (eGFR), end-stage renal disease, or all-cause mortality. Results: The severity of clinical symptoms and laboratory indices, such as blood pressure; extent of edema and hematuria; levels of fibrinogen, immunoglobulin (Ig)-G, complement (C)-4, total protein, albumin (ALB), and serum creatinine (SCr); and eGFR increased with increasing proteinuria (all p< .001). Based on renal histopathology, the extent of segmental sclerosis and balloon adhesion and renal interstitial lesion stage also increased in severity with increasing proteinuria (all p< .001). The Kaplan–Meier analysis showed that compared with patients with low and medium levels of proteinuria, patients with high levels of proteinuria had significantly lower cumulative poor event-free renal survival rates (p= .0039). Conclusions: Baseline proteinuria level is indicative of prognosis in IMN patients; the greater the extent of proteinuria is, the worse the prognosis.http://dx.doi.org/10.1080/0886022X.2019.1605294idiopathic membranous nephropathyproteinuriaprognosisend-stage renal diseaseremission
spellingShingle Xinxin Chen
Yu Chen
Xiaokai Ding
Ying Zhou
Yinqiu Lv
Duo Li
Bo Chen
Tianxin Chen
Chaosheng Chen
Baseline proteinuria level is associated with prognosis in idiopathic membranous nephropathy
Renal Failure
idiopathic membranous nephropathy
proteinuria
prognosis
end-stage renal disease
remission
title Baseline proteinuria level is associated with prognosis in idiopathic membranous nephropathy
title_full Baseline proteinuria level is associated with prognosis in idiopathic membranous nephropathy
title_fullStr Baseline proteinuria level is associated with prognosis in idiopathic membranous nephropathy
title_full_unstemmed Baseline proteinuria level is associated with prognosis in idiopathic membranous nephropathy
title_short Baseline proteinuria level is associated with prognosis in idiopathic membranous nephropathy
title_sort baseline proteinuria level is associated with prognosis in idiopathic membranous nephropathy
topic idiopathic membranous nephropathy
proteinuria
prognosis
end-stage renal disease
remission
url http://dx.doi.org/10.1080/0886022X.2019.1605294
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