scholarly journals P0128COMPARISON OF ULTRASTRUCTURE FEATURES BETWEEN PATIENTS WITH MERCURY-ASSOCIATED MEMBRANOUS NEPHROPATHY AND IDIOPATHIC MEMBRANOUS NEPHROPATHY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Aibo Qin ◽  
Zishan Lin ◽  
Fude Zhou ◽  
Minghui Zhao ◽  
Suxia Wang ◽  
...  
Keyword(s):  
Membranous Nephropathy ◽  
Prolonged Exposure ◽  
High Sensitivity ◽  
Clinicopathological Features ◽  
Idiopathic Membranous Nephropathy ◽  
Dense Deposits ◽  
Foot Process ◽  
The Difference ◽  
Potential Tool ◽  
Glomerular Capillaries

Abstract Background and Aims Prolonged exposure to mercury can cause membranous nephropathy. The routine clinicopathological features of mercury-associated membranous nephropathy (M-MN) and idiopathic membranous nephropathy (I-MN) are similar. The difference in ultrastructure between them was observed clinically. The current study retrospectively compared the ultrastructure features, clinical and pathological data, treatment and prognosis of patients with M-MN and I-MN. Method Thirteen patients with M-MN and 13 patients with I-MN were enrolled. The clinical and pathological data were retrospectively collected. Electron micrographs of glomerular capillaries were taken and the foot process width (FPW) and the number of foot processes per 10 μm glomerular basement membrane (GBM) were measured. The presence and location of electron-dense deposits in mesangium and subendothelial region were recorded. Results Patients with M-MN were younger (38.7±8.5 versus 45.8±5.7 years, P=0.020), with a shorter duration of complete remission (9.0±6.1 versus 20.3±9.8 months, P=0.004) and lower relapse rate (0% versus 45.5%, P=0.014) than patients with I-MN. As to ultrastructure, patients with M-MN had lower levels of FPW [974.3nm (range 791.2∼1504.4) versus 2370.6nm (range 2219.4∼2559.1), P=0.001, Figure 1], more foot processes per 10 μm GBM [8.1 (range 5.2∼10.0) versus 3.3 (range 3.1∼3.5), P=0.001], and higher ratio of mesangial electron-dense deposits (41.7% versus 0, P=0.015, Figure 2) than those with I-MN. Multivariate analysis showed that type of disease (M-MN or I-MN) and stage of MN (stageIor stageIIand above) were the two only determinants of FPW. FPW over 1645 nm differentiated M-MN from I-MN with high sensitivity (92.3%) and specificity (83.3%). Conclusion The quantitative analysis of foot processes may offer a potential tool to distinguish M-MN from I-MN. Better prognosis in patients with M-MN may be related to minor podocyte damage.

scholarly journals The correlation between Serum phospholipase A2 receptor antibody and clinicopathological features in patients with membranous nephropathy

2021 ◽  
Vol 5 (2.1) ◽  
pp. 8
Author(s):  
Qipeng Huang ◽  
Gaosi Xu ◽  
Fang Wang ◽  
Fang Zeng ◽  
Weidong Fang
Keyword(s):  
Phospholipase A2 ◽  
Membranous Nephropathy ◽  
Clinicopathological Features ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Idiopathic Membranous Nephropathy ◽  
Receptor Antibody ◽  
Phospholipase A2 Receptor ◽  
Normal Controls

Objective: To assess the correlation between Serum phospholipase A2 receptor antibody and clinicopathological features in patients with membranous nephropathy. Method: The patients being hospitalized for renal biopsy were selected in this study from January 2016 to January 2018. And normal controls were randomly selected; all the patients were divided into idiopathic membranous nephropathy and non-idiopathic membranous nephropathy groups; patients with idiopathic membranous nephropathy were divided into three groups, namely stage I, stage II and stage III; using software for statistical analysis. Results: A total of 357 patients were enrolled, including 155 patients with idiopathic membranous nephropathy, 183 patients with non-idiopathic membranous nephropathy, and 19 cases for normal controls. The average age of the idiopathic membranous nephropathy (IMN) group is higher than that of the membranous nephropathy group (P = 0.01). Different pathological stages of idiopathic membranous nephropathy general clinical characteristics analysis results showed that the age, cys c, serum creatinine (Scr) in stage III membranous nephropathy group were higher than those of the stage I and II membranous nephropathy (P values were 0.003, 0.000 and 0.000 respectively); titers of serum phospholipase A2 receptors antibody with stage II and III membranous nephropathy higher than the stage I membranous nephropathy group (P = 0.006); serum albumin (Alb) levels correlated inversely with serum anti-PLA2R antibody titers (rs = –0.234, P = 0.003), serum antiphospholipase A2 receptor (PLA2R) antibody titer level in patients with idiopathic membranous nephropathy was significantly higher than that in patients with non-membranous nephropathy (P < 0.001). Conclusion: Baseline titer of serum anti-PLA2R antibody is negatively correlated with Alb in the IMN patients，and serum anti-PLA2R antibody level in patients with stage I IMN was significantly lower than stage II and III IMN patients.

scholarly journals Retrospective study: clinicopathological features and prognosis of idiopathic membranous nephropathy with seronegative anti-phospholipase A2 receptor antibody

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e8650 ◽  
Author(s):  
Wenkai Guo ◽  
Yan Zhang ◽  
Caifeng Gao ◽  
Jing Huang ◽  
Jiatong Li ◽  
...  
Keyword(s):  
Membranous Nephropathy ◽  
Remission Rate ◽  
Clinical Manifestations ◽  
Renal Tissue ◽  
Clinicopathological Features ◽  
Idiopathic Membranous Nephropathy ◽  
Positive Staining ◽  
Urine Protein ◽  
Phospholipase A2 Receptor ◽  
Beta 2 Microglobulin

Background To discuss the clinicopathological features and prognosis of patients with idiopathic membranous nephropathy (IMN) who are serum-negative for the anti-PLA2R antibody. Method Overall, 229 IMN patients were retrospectively collected in this study and classified into anti-PLA2R antibody-negative (PLA2R−, 59 cases) and antibody-positive (PLA2R+, 170 cases) groups. The clinical and pathological features of the PLA2R− group were analyzed; 162 patients in both groups were followed up, and the PLA2R antigen was detected in renal biopsies from the PLA2R− group. Kaplan-Meier and survival analyses were used to compare differences in prognosis. Results Serum albumin levels were higher and 24-hour urine protein, creatinine, and beta 2-microglobulin (BMG) levels were lower in the PLA2R− group than in the PLA2R+ group; the proportion of acute and chronic tubular lesions was also significantly lower in the PLA2R− group than in in the PLA2R+ group. After treatment, the remission rate was significantly higher in the negative group than in the positive group (93.02% vs 74.78%,), especially the rate of complete remission (51.16% vs 23.47%). Furthermore, the PLA2R antigen-positive staining rate of 43 patients in the PLA2R− group was 62.79%. Although not significant, the survival rate was higher in the PLA2R− group than in the PLA2R+ group. BMG, 24-hour urine protein and acute and chronic tubular lesions were risk factors for kidney death, and 24-hour urine protein was an independent risk factor for kidney death. Conclusions Compared with the PLA2R+ group, the PLA2R− group had mild clinical manifestations and pathological damage and a higher clinical treatment remission rate. Renal tissue PLA2R antigen testing can be considered for patients with seronegative IMN to increase the diagnostic rate.

scholarly journals Clinical Characteristics and Outcomes of Idiopathic Membranous Nephropathy with Glomerular Igm Deposits

2021 ◽  
Author(s):  
Yu-Zhu Xu ◽  
Na-Ya Huang ◽  
Ya-Gui Qiu ◽  
Xiong-Hui Chen ◽  
Zhi-Jian Li ◽  
...  
Keyword(s):  
Membranous Nephropathy ◽  
Cox Regression ◽  
Clinicopathological Features ◽  
Idiopathic Membranous Nephropathy ◽  
Rank Test ◽  
Cox Regression Analysis ◽  
Focal Segmental Glomerular Sclerosis ◽  
Log Rank Test ◽  
Treatment Responses ◽  
Egfr Decline

Abstract BackgroundGlomerular IgM deposition is commonly shown in idiopathic membranous nephropathy (IMN), but the clinicopathological features and outcomes of IMN with IgM deposition are unclear.MethodsThis single-center prospective cohort study enrolled 210 patients with biopsy-proven IMN from January 2016 to December 2018. Clinicopathological features, treatment responses, and kidney outcomes were compared between patients with and without IgM deposition.Results76 (36.2%) patients shown glomerular IgM deposition. Patients with IgM deposition were younger (45±13.296 vs. 50.59±13.65 years, P=0.006), had a higher estimated glomerular filtration rate (eGFR) (100.03 [81.31–111.37] vs. 92.67 [74.71–106.63] mL/min/1.73 m2, P=0.041), and had a lower proportion of nephrotic syndrome (60.5% vs. 75.4%, P=0.024) at the time of kidney biopsy. Patients with IgM deposition had a significantly higher proportion of focal segmental glomerular sclerosis (FSGS) lesions (27.6% vs. 13.4%, P=0.011) and C1q deposition (72.4% vs. 57.5%, P=0.032). Although the treatments and initial treatment responses were comparable, patients with glomerular IgM deposition had a significantly greater proportion of eGFR decline of ≥5 mL/min/1.73 m2 per year (log-rank test, P<0.001) and eGFR decrease of ≥10% from baseline (log-rank test, P=0.003). Cox regression analysis showed that IgM deposition was an independent risk factor of eGFR decline of ≥5 mL/min/1.73 m2 per year (HR, 2.442; 95% CI, 1.550–3.848, P<0.001) and eGFR decline by ≥10% from baseline (HR, 2.629; 95% CI, 1.578–4.385, P<0.001) during follow-up.ConclusionsGlomerular IgM deposition is associated with younger age, more severe FSGS lesions and C1q deposition, and worse renal outcomes in IMN.

Sign in / Sign up

Export Citation Format

Share Document