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Correlation of clinicopathological characteristics and histological findings with renal outcome in patients with primary membranous neprhopathy (Master thesis)

Δουμάνη - Κόρκα, Γεωργία/ Doumani - Korka, Georgia

Background. Primary Membranous Glomerulonephropathy or Nephropathy (MN) constitutes the most frequent cause of nephrotic syndrome in non-diabetic adults worldwide. MN is an autoimmune disease attacking the kidney glomerulus, characterized by diffuse subepithelial deposits of immune complexes. The recent identification of the phospholipase A2 receptor (PLA2R), as principal target antigen of autoantibodies and the discovery of novel antigens thereon have changed patients’ approach. Considerable effort is made towards characterization of prognostic factors affecting outcome of MN in order to achieve optimal disease management. Methods. Clinicopathological characteristics and histological findings of 88 patients diagnosed with biopsy-proven primary MN, recruited from January 2000 through December 2023 and treated at a tertiary Greek hospital were retrospectively studied. The primary endpoint was defined as a greater than 50% reduction in eGFR or/and ESRD or/and death. Results. Mean follow-up period was 110 months. At diagnosis patients presented with preserved renal function (eGFR 90ml/min/1.73 m2), nephrotic range proteinuria (7.4 g/day), 45.7% were AbPLA2R positive, 72.3% were diagnosed at stage 2 according to Ehrenreich and Chugh classification. Stepwise logistic regression was conducted that revealed correlation between age at diagnosis and state of no remission (pvalue<0.002), as well as between proteinuria at 12 months and primary endpoint (pvalue<0.012). Conclusions. In this single-center retrospective observational study findings were consistent to a significant extent with those published in the literature. Investigation into clinicopathological characteristics and histological findings revealed correlation between age at diagnosis and state of no remission, as well as between proteinuria at 12 months and primary endpoint.