Abstract
Objective
To assess the significance of focal segmental glomerulosclerosis (FSGS) variants on clinicopathological characteristics and short-term outcomes in idiopathic membranous nephropathy (IMN) patients.
Methods
The clinicopathological data of 146 IMN patients diagnosed between December 2016 and March 2019 in our center were collected and analyzed. These patients were divided into the pure IMN group, IMN with glomerular tip lesion (GTL) group, and IMN with non-GTL FSGS group.
Results
The IMN with non-GTL FSGS and IMN with GTL groups both had higher proportions of patients with hypertension, lower serum albumin, and severe proteinuria, while the IMN with non-GTL FSGS group additionally showed higher blood pressure and serum cholesterol, and lower serum IgG than the IMN group (all P<0.05). As for pathology, the IMN with non-GTL FSGS group had higher proportions of patients with acute tubular injury and moderate to severe chronic injuries than the IMN group (all P<0.05). In the IMN, IMN with GTL, and IMN with non-GTL FSGS groups, the overall one-year remission rates were 81.6%, 76%, and 58.8%, respectively. Furthermore, the IMN with non-GTL FSGS group showed the lowest cumulative incidence to reach remission within one year. Multivariate Cox logistic analysis demonstrated that higher level of serum anti-M-type phospholipase A2 receptor antibody and the existence of non-GTL FSGS lesion were independent predictors for no remission in IMN patients.
Conclusion
The non-GTL FSGS lesion was a novel negative predictor in IMN and should be taken into account in the management of IMN.
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Acknowledgments
We appreciate the help of Fang TANG, Li-xia YI and Hong-yan ZHU for providing the pathologic support.
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Author Chun ZHANG is a member of the Editorial Board for Current Medical Science. The paper was handled by other editors and has undergone rigorous peer review process. Author Chun ZHANG was not involved in the journal’s review of, or decision related to, this manuscript.
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This work was financially supported by grants from the National Natural Science Foundation of China (No. 81961138007, No. 81974096 and No. 81770711), the National Key Research and Development Program (No. 2020YFC0845800 and No. 2018YFC1314000), the Program for HUST Academic Frontier Youth Team (No. 2017QYTD20), and the Natural Science Foundation of Hubei Province (No. 2017CKB899).
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Wang, H., Wan, C., Jiang, M. et al. Non-glomerular Tip Lesion Focal Segmental Glomerulosclerosis as a Negative Predictor in Idiopathic Membranous Nephropathy. CURR MED SCI 42, 1007–1014 (2022). https://doi.org/10.1007/s11596-022-2628-y
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DOI: https://doi.org/10.1007/s11596-022-2628-y