Abstract: FR-PO0672
Application of the Focal, Segmental, Tubular, Interstitial, and Vascular Score and Mayo Clinic Chronicity Score in Idiopathic Membranous Nephropathy: Clinical and Prognostic Value
Session Information
- Glomerular Diseases: Clinical, Outcomes, and Therapeutics Research - ANCA/FSGS
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Liu, Yonghua, People’s Hospital of Ningxia Hui Autonomous Region, Yinchuan, Ningxia, China
- E, Jing, People’s Hospital of Ningxia Hui Autonomous Region, Yinchuan, Ningxia, China
- Zhou, Xiaoling, People’s Hospital of Ningxia Hui Autonomous Region, Yinchuan, Ningxia, China
Background
To evaluate the clinical and prognostic value of the FSTIV score (F: focal, S: segmental, T: tubular, I: interstitial, V: vascular) and the Mayo Clinic Chronicity Score (MCCS) in patients with idiopathic membranous nephropathy (IMN).
Methods
This retrospective cohort study included 139 patients with biopsy proven IMN at Ningxia Hui Autonomous Region People’s Hospital (June 2019–September 2023). Pathological chronicity was assessed using FSTIV (0–4 points) and MCCS (0–10 points). FSTIV was derived from four histological parameters (focal segmental glomerulosclerosis, tubular atrophy, interstitial fibrosis, vascular hyalinosis); MCCS from glomerulosclerosis, interstitial fibrosis, tubular atrophy, and arteriosclerosis. Treatment response was evaluated at 6 months, defined as ≥50% reduction in 24 hour urine protein with stable or improved serum creatinine. Logistic regression was used to assess associations between the scoring systems and treatment response.
Results
Among 139 patients, FSTIV distribution: 0-1 point (24.4%), 2 points (20.1%), 3 points (28.7%), 4 points (26.6%). MCCS distribution: 0-1 point (26.6%), 2-4 points (58.9%), 5-7 points (12.2%), ≥8 points (2.1%). Higher FSTIV and MCCS grades were significantly associated with older age, higher prevalence of hypertension and nephrotic syndrome, lower serum albumin, higher proteinuria, and worse renal function (all P<0.05). At 6 months, remission rates by increasing FSTIV grades were 76.4%, 87.5%, 61.8%, and 39.0%; by MCCS grades: 73.0%, 76.8%, 46.1%, and 66.7%. Higher scores predicted poorer renal recovery regardless of treatment regimen. Although total FSTIV or MCCS scores were not independently associated with treatment response in multivariate analysis, tubular atrophy and interstitial fibrosis individually were significant predictors of poor response.
Conclusion
Both FSTIV and MCCS chronicity scores correlate with baseline disease severity and short term treatment response in IMN. Higher scores indicate more severe renal impairment and worse prognosis. While total scores lack independent predictive value, tubular atrophy and interstitial fibrosis are important predictors of treatment outcomes. Given the predominantly mild chronic changes in this cohort, the FSTIV grading system appears superior to MCCS and may be more suitable for early clinical assessment and risk stratification.