Factors contributing to the outcome in 100 adult patients with idiopathic membranous glomerulonephritis.
Follow-up data on 100 patients with idiopathic membranous glomerulonephritis (IMGN), in whom renal biopsy has been performed, are discussed. The period of follow-up ranged from 3 to 24 years (median 7.8 years). Sixteen of the patients had end-stage renal disease. Complete remission of renal disease occurred in 41 patients. The remaining 43 patients exhibited persisting renal functional abnormalities at the end of the follow-up period. Using Cox's proportional hazard model, six parameters were found as predictive factors for prognosis at the time of biopsy: serum cholesterol level > 260 mg/dl, serum creatinine concentration > 1.4 mg/dl, the presence of tubulointerstitial (TI), vascular, mesangial, and Bowman's capsular lesions. No effect was observed in the size of subepithelial electron dense deposits (SED) on prognosis. A weakly positive correlation was found between the thickness of the glomerular basement membrane (GBM) and poor outcome. Treatment with steroid and/or immunosuppressive agents was not found to improve survival. Assessment of these factors thus allows the pathologist to make a relevant statement concerning the probable course and prognosis of the disease at the time of the diagnostic biopsy.
Tóth
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Second Department of Pathology, School of Medicine, Fukuoka University, Japan.
Takebayashi
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D000328:Adult; D005260:Female; D015433:Glomerulonephritis, Membranous / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D006801:Humans; D007668:Kidney / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015996:Survival Rate