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Kidney Week

Abstract: TH-PO1014

Clinical Implications of Pathological Features of Primary Membranous Nephropathy

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Zhang, Xiao-dan, Renal Division, Peking University First Hospital, Beijing, China
  • Cui, Zhao, Peking University First Hospital, Beijing, China
  • Zhao, Minghui, Peking University First Hospital, Peking University, Beijing, China
Background

The clinical outcome varies considerably in primary membranous nephropathy (pMN). It was controversial whether the histopathological features of pMN could predict treatment response and kidney outcome.

Methods

A retrospective study was conducted in 371 patients with biopsy-proven pMN. Pathological parameters included immunofluorescence staining, membranous Churg’s stages, sclerosis, crescent, focal segmental sclerosis lesion, chronic and acute tubulointerstitial injury.

Results

We found that patients with higher intensity of C3 staining, advanced membranous stage, and more severe chronic tubulointerstitial injury presented with higher positivity rate of anti-PLA2R antibodies, higher levels of urinary protein excretion and serum creatinine, and lower level of serum albumin. Univariate Cox regression analysis showed that severe (grade=3) chronic tubulointerstitial injury was a risk factor to the kidney outcome of ESKD and over 50% reduction of eGFR. Multivariate analysis demonstrated it as an independent risk factor to ESKD.

Conclusion

We found the prognostic role of chronic tubulointerstitial injury to the kidney outcome of pMN. This study highlighted the value of kidney biopsy under the widespread usage of anti-PLA2R antibodies for diagnosis and prognosis.