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Abstract: TH-PO632

The Epidemiology of Primary Membranous Nephropathy: A Single-Centre Study over Two Decades

Session Information

Category: Glomerular Diseases

  • 1402 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Storrar, Joshua, Northern Care Alliance NHS Foundation Trust, Salford, Manchester, United Kingdom
  • Chinnadurai, Rajkumar, Northern Care Alliance NHS Foundation Trust, Salford, Manchester, United Kingdom
  • Kalra, Philip A., Northern Care Alliance NHS Foundation Trust, Salford, Manchester, United Kingdom
  • Sinha, Smeeta, Northern Care Alliance NHS Foundation Trust, Salford, Manchester, United Kingdom
Background

Membranous nephropathy is the commonest cause of nephrotic syndrome in non-diabetic White adults over the age of 40, and can be either primary (pMN) or secondary. Management aims to induce remission- spontaneously with supportive care, or with immunosuppression (IS). Here, we describe the natural history of this condition in a large tertiary centre in the UK.

Methods

178 patients with pMN were identified over 2 decades. We collected data on demographics, baseline laboratory values, treatment received and outcomes including progression to renal replacement therapy (RRT) and mortality. Analysis was performed on the whole cohort and specific subgroups.

Results

Median age was 58.3 years with 63.5% male. Median baseline eGFR was 76.7mls/min/1.73m2 and urine protein-creatinine ratio 664g/mol. Remission (partial or complete) was achieved in 134 (75.3%), either spontaneous in 60 (33.7%) or after treatment with IS in 74 (41.6%), and of these 57 (42.5%) relapsed. Progression to RRT was seen in 10.1% with mortality in 29.8%. Those who went into remission had improved outcomes compared to those who did not (less progression to RRT [4.5% vs 28%] and death [20.1% vs 67%]). Those classified as high risk as per KDIGO also had worse outcomes than those at low risk (mortality seen in 52.6% vs 10.8%, p<0.001).

Conclusion

We provide a comprehensive epidemiologic analysis of pMN at a large tertiary UK centre. Only 10.1% progressed to RRT (much lower than classically reported). For novelty, the KDIGO risk classification was linked to outcomes, highlighting its utility for identifying patients most likely to progress.

The Salford glomerulonephritis research group was supported by an unrestricted project grant from CSL Vifor.

Baseline demographics, laboratory values and major outcomes for the total cohort.

Funding

  • Commercial Support – CSL Vifor