Clinical nephrology · 2026
Renal survival in idiopathic membranous nephropathy: The impact of chronicity score and clinical predictors.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Kocaayan Hasan, Uzum Yusuf, Ertekin Ibrahim, Cakalagaoglu Fulya, Soypacaci Zeki
Аннотация
OBJECTIVE: Renal survival is crucial in patients with idiopathic membranous nephropathy (IMN). Our aim was to identify baseline clinical and histopathological predictors of long-term renal survival in patients with IMN.
MATERIALS AND METHODS: In this retrospective, single-center cohort study, we reviewed 50 adults with biopsy-proven IMN (January 2009 - February 2019) who completed at least 60 months of follow-up. We recorded baseline age, sex, serum creatinine, serum albumin, 24-hour proteinuria, and the total renal chronicity score (Mayo Clinic Chronicity Score). Chronicity was classified as minimal (score 0 - 1) or non-minimal (score ≥ 2). The renal endpoint was defined as a ≥ two-fold increase in serum creatinine from baseline or the initiation of renal replacement therapy (RRT). Predictors of renal survival were assessed using univariate and multivariate Cox regression; renal survival probability was illustrated with Kaplan-Meier analysis.
RESULTS: During the 5-year follow-up, 20 out of 50 patients (40%) reached the renal endpoint. Kaplan-Meier curves demonstrated a significant divergence: only 1 out of 30 patients (3.3%) in the minimal-chronicity group progressed, while 19 out of 20 patients (95%) with non-minimal chronicity experienced either a doubling of creatinine or required RRT (log-rank p < 0.001). In univariate analysis, older age, higher serum creatinine, lower serum albumin, albumin levels below 3 g/dL, and non-minimal chronicity were associated with poor outcomes. Multivariate Cox regression confirmed three independent predictors: baseline serum creatinine (HR 2.38, 95% CI 1.37 - 4.11, p = 0.02), serum albumin (HR 0.43, 95% CI 0.23 - 0.80, p = 0.008), and non-minimal chronicity score (HR 14.4, 95% CI 3.2 - 64.6, p < 0.001).
CONCLUSION: In IMN, a high total renal chronicity score on biopsy, elevated baseline serum creatinine, and hypoalbuminemia (< 3 g/dL) independently predict poor 5-year renal survival. Early recognition of non-minimal chronicity may facilitate timely therapeutic intervention and closer monitoring to mitigate progression to end-stage kidney disease.
MATERIALS AND METHODS: In this retrospective, single-center cohort study, we reviewed 50 adults with biopsy-proven IMN (January 2009 - February 2019) who completed at least 60 months of follow-up. We recorded baseline age, sex, serum creatinine, serum albumin, 24-hour proteinuria, and the total renal chronicity score (Mayo Clinic Chronicity Score). Chronicity was classified as minimal (score 0 - 1) or non-minimal (score ≥ 2). The renal endpoint was defined as a ≥ two-fold increase in serum creatinine from baseline or the initiation of renal replacement therapy (RRT). Predictors of renal survival were assessed using univariate and multivariate Cox regression; renal survival probability was illustrated with Kaplan-Meier analysis.
RESULTS: During the 5-year follow-up, 20 out of 50 patients (40%) reached the renal endpoint. Kaplan-Meier curves demonstrated a significant divergence: only 1 out of 30 patients (3.3%) in the minimal-chronicity group progressed, while 19 out of 20 patients (95%) with non-minimal chronicity experienced either a doubling of creatinine or required RRT (log-rank p < 0.001). In univariate analysis, older age, higher serum creatinine, lower serum albumin, albumin levels below 3 g/dL, and non-minimal chronicity were associated with poor outcomes. Multivariate Cox regression confirmed three independent predictors: baseline serum creatinine (HR 2.38, 95% CI 1.37 - 4.11, p = 0.02), serum albumin (HR 0.43, 95% CI 0.23 - 0.80, p = 0.008), and non-minimal chronicity score (HR 14.4, 95% CI 3.2 - 64.6, p < 0.001).
CONCLUSION: In IMN, a high total renal chronicity score on biopsy, elevated baseline serum creatinine, and hypoalbuminemia (< 3 g/dL) independently predict poor 5-year renal survival. Early recognition of non-minimal chronicity may facilitate timely therapeutic intervention and closer monitoring to mitigate progression to end-stage kidney disease.
Предметные рубрики MeSH
Follow-Up StudiesRetrospective StudiesHumansMaleFemaleAdultMiddle AgedRisk FactorsKidneyChronic DiseaseProportional Hazards ModelsKaplan-Meier EstimateGlomerulonephritis, MembranousChronic Disease IndicatorsCreatinineSerum AlbuminProteinuriaPredictive Value of TestsKidney Failure, ChronicDisease Progression