Retrospective Investigation of the Factors Associated with Remission in Patients Diagnosed Primary Membranous Glomerulonephritis

Introduction: The present study aims to investigate the demographic, clinical, and pathological characteristics of patients followed up with a diagnosis of primary membranous glomerulonephritis (MGN) and the effects of the treatments applied on remission. Methods: Sixty patients older than 18 years of ages, whose primary MGN diagnosis was confirmed by kidney biopsy and followed for at least 12 months between 2006 and 2012 were included in the study. The patients were divided into 3 groups according to the state of remission. The groups were compared in terms of their demographic, clinical, laboratory, and histopathological findings. Results: Of the patients, 37 (63%) were male, the mean age was 55.7±14.8 years. While 44 (73.3%) patients were followed up with immunosuppressive treatment, 16 (26.7%) patients were followed only with conservative treatment. A high level of proteinuria (p=0.002) and male gender dominance were found in the group that received immunosuppressive therapy (p=0.01). A total of 18 (29.6%) patients had complete remission at the end of 12 months. Partial remission occurred in 30 (50%) of the patients. Female gender (p=0.02) and receiving immunosuppressive therapy (p=0.01) were independent factors associated with the development of complete or partial remission; the presence of lower glomerular sclerosis (p=0.03) was associated with complete remission. We did not find any relationship between the intensity of immune deposition and the state of being in remission. Conclusion: Female gender and the presence lower glomerulosclerosis are indicators of good prognosis in primary MGN. In addition, immunosuppressive therapy positively affects the prognosis.

___

  • 1. Seitz-Polski B, Dolla G, Payre C, Girard CA, Polidori J, Zorzi K, et al. Epitope spreading of autoantibody response to PLA2R associates with poor prognosis in membranous nephropathy. J Am Soc Nephrol. 2016; 27: 1517–1533.
  • 2. Radice A, Trezzi B, Maggiore U, Pregnolato F, Stellato T, Napodano P, et al. Clinical usefulness of autoantibodies to M-type phospholipase A2 receptor (PLA2R) for monitoring disease activity in idiopathic membranous nephropathy (IMN). Autoimmun Rev. 2016; 15: 146–154.
  • 3. Beck LH, Bonegio RG, Lambeau G, Beck DM, Powell DW, Cummins TD, et al. M-type phospholipase A2 receptor as target antigen in idiopathic membranous nephropathy. N Engl J Med. 2009;361(1):11-21.
  • 4. Akiyama S, Akiyama M, Imai E, Ozaki T, Matsuo S, Maruyama S. Prevalence of anti-phospholipase A2 receptor antibodies in Japanese patients with membranous nephropathy. Clin Exp Nephrol. 2015;19(4):653-60.
  • 5. Du Y, Li J, He F, Lv Y, Liu W, Wu P, et al. The diagnosis accuracy of PLA2R-AB in the diagnosis of idiopathic membranous nephropathy: a meta-analysis. PLoS One 2014;9:e104936
  • 6. Cossey LN, Walker PD, Larsen CP. Phospholipase A2 receptor staining in pediatric idiopathic membranous glomerulopathy. Pediatr Nephrol 2013;28:2307–11.
  • 7. Hoxha E, Harendza S, Pinnschmidt HO, Tomas NM, Helmchen U, Panzer U, et al. Spontaneous remission of proteinuria is a frequent event in phospholipase A2 receptor antibody-negative patients with membranous nephropathy. Nephrol Dial Transplant. 2015; 30: 1862–1869.
Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi-Cover
  • ISSN: 1300-6622
  • Yayın Aralığı: Yıllık
  • Başlangıç: 2015
  • Yayıncı: -
Sayıdaki Diğer Makaleler

Hüseyin ÖZKÖK, Mümtaz YILMAZ, Sait ŞEN, Aygül ÇELTİK, Banu SARSIK KUMBARACI, Meltem SEZİŞ DEMİRCİ, Gülay AŞÇI

Treatment Management of Leptomeningeal and Brain Metastases as a First Reccurence Site in a Case with Germ Cell Testicular Tumor

Sabin GÖKTAŞ AYDIN, Ahmet BİLİCİ, Aslı ÇAKIR, Ömer Fatih ÖLMEZ, Ayşenur CİLA, Dilek ÜNAL

Erişkinlerde serum kobalamin düzeyinin yüksekliği ileri tetkik veya takip gerektirir mi?

Işıl ERDOĞAN ÖZÜNAL, Taner TAN, Erman ÖZTÜRK

Sağlık Hizmetleri Meslek Yüksekokulu öğrencilerinin geleneksel ve tamamlayıcı tıp ve ilişkili enfeksiyon kontrol önlemleri hakkında bilgi düzeylerinin incelenmesi

Aysun ÖZLÜ, Sevil ALKAN, Emine Kübra DİNDAR DEMİRAY, Hatice ÖNTÜRK, Şebnem ŞENOL AKAR

Severe Immune Thrombocytopenia in Pregnancy Treated with Eltrombopag. A Case Report.

Serkan GÜVEN, Hakan AKTUNA, Seval AKPINAR, Burhan TURGUT

Evaluation of adult patients with hereditary spherocytosis

Emrah KILIÇASLAN, Selim SAYIN, Murat YILDIRIM, Tayfun ELİBOL, Hilmi Erdem GÖZDEN, Meltem AYLI, Muhammet Kürşat KAPTAN

Psöriatik Artrit Hastalarında Hastalık Şiddeti ile QT Dispersiyonu Arasındaki İlişki

Özgül SOYSAL GÜNDÜZ, Kezban ARMAĞAN ALPTÜRKER

COVID-19 SOKAĞA ÇIKMA KISITLAMASI SÜRESİNCE ÇOCUKLARDA YABANCI CİSİM ASPİRASYONLARI; YASAKLAR ÇOCUKLARA ZARARLI MI?

Sevim ÇAKAR, Gülin ERDEMİR EREN, Cahit Barış ERDUR, Kübra Evren ŞAHİN, Çiğdem Ömür ECEVİT, Özlem BEKEM

Koagülasyon Testlerinde Altı Sigma Yöntemi ve Değerlendirilmesi

Mert ÜĞE, Mehmet Hicri KÖSEOĞLU, Serap ÇUHADAR, Figen NARİN

Bebeklik dönemindeki kolik ağrıları ailesel Akdeniz Ateşini öngörebilir mi?

Özge ALTUĞ GÜCENMEZ