Abstract: TH-PO129

Factors Influencing Initial Treatment Options for Idiopathic Membranous Nephropathy

Session Information

Category: Glomerular

  • 1005 Clinical Glomerular Disorders

Authors

  • Xie, Huaiya, Peking Union Medical College Hospital, Beijing, China
  • Zhang, Xin, Peking University First Hospital, Beijing, China
  • Wu, Zhen, Beijing Frendship Hospital, Capital Medical University, Beijing, China
  • Wen, Yubing, Peking Union Medical College Hospital, Beijing, China
  • Cai, Jianfang, Peking Union Medical College Hospital, Beijing, China
  • Li, Hang, Peking Union Medical college hosiptal, Beijing, China
  • Li, Xuemei, Peking Union Medical College Hospital, Chinese Academy of Medicine Sciences & Peking Union Medical College, Beijing, China
  • Li, Xuewang, Peking Union Medical College Hospital, Beijing, China
Background

This study aimed to analyze factors which may influence the initial therapy option for idiopathic membranous nephropathy (IMN) diagnosed in a tertiary center of China.

Methods

In this retrospective study, we consecutively enrolled 875 IMN patients diagnosed in a single tertiary center between 2004 to 2015. Data on age, sex, body mass index, presence of hypertension and diabetes mellitus, and laboratory tests at renal biopsy and treatment options after diagnosis of IMN were retrospectively retrieved from medical records. We retrospectively classified the initial therapy as glucocorticoids plus cyclophosphamide, calcineurin inhibitors alone or plus corticosteroids, corticosteroids alone or plus other immunosuppressives, and supportive treatment. Multinomial multiple logistic regression was employed to analyze the factors influencing the selection of a therapeutic regimen.

Results

The presence of diabetes(OR=5.06, 95% CI 2.90-8.84, P<0.001) and age <50 years was associated with selection of calcineurin inhibitors(OR=1.48, 95% CI 1.00-2.17, P=0.048), whereas a 24 hour urine total protein(24h-UP)<8g and a serum albumin> 25g/L were associated with selection of supportive treatment (OR=15.2, 95% CI 3.53-65.1, P<0.001 and OR=21.3, 95% CI 5.09-89.5, respectively) and corticosteroids alone or plus other immunosuppressives(OR=4.93, 95% CI 2.52-9.64, P<0.001 and OR=1.69, 95% CI 1.05-2.74, respectively) as opposed to selection of cyclophosphamide. When we restricted the analyses in non-diabetes patients, age <50 years was also associated with selection of calcineurin inhibitors as compared with selection of cyclophosphamide(OR=1.69, 95% CI 1.12-2.54, P=0.012).

Conclusion

Serum albumin level, amount of 24h-UP, presence of diabetes, and age may influence a physician’s decision on initial treatment options for IMN.