title: Long-term outcome and prognostic factors of idiopathic membranous nephropathy in the Chinese population.
abstract: BACKGROUND
  Idiopathic membranous nephropathy (IMN) is a representative form of nephrotic syndrome in China. Although IMN is thought to run a more benign course in Asian patients than in the Caucasian population, there has been no persuasive study to determine the long-term prognosis and risk factors for IMN in the Chinese population.
  
  
  METHODS
  A retrospective chart review. All patients admitted to Nanjing Institution of Nephrology from January 1985 to December 2007 with biopsy-proven IMN were enrolled. The primary outcome was the renal survival rate and risk factors at renal biopsy.
  
  
  RESULTS
  A total of 217 patients were included in the study, and the overall renal survival rates were 96.9%, 93.5%, and 86.6% at 5, 10, and 15 years after renal biopsy, respectively. When the clinical features at biopsy were evaluated, patients with hypertension (p = 0.023), decreased eGFR (p < 0.001), nephrotic-range proteinuria (p = 0.047), elevated urinary NAG (p = 0.045) and RBP (p = 0.007) had a worse prognosis. Cox multivariate analysis showed that decreased eGFR and chronic tubulointerstitial lesion were independent risk factors for ESRF (end-stage renal failure).
  
  
  CONCLUSIONS
  IMN is a disease with a comparatively good prognosis in the Chinese population, with a renal survival rate of more than 90% at 10 years after renal biopsy. Decreased eGFR at biopsy and chronic tubulointerstitial lesion are independent risk factors of ESRF. Partial or complete remission of proteinuria improved the prognosis.
authors: Research Institute of Nephrology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors: Ke
authors: K
authors: Zuo
authors: Yan
authors: Y
authors: Wu
authors: Shi-Jun
authors: SJ
authors: Li
authors: Feng
authors: F
authors: Xu
authors: Cai-Hong
authors: CH
authors: Zeng
authors: Zhi-Hong
authors: ZH
authors: Liu
mesh_terms: D000328:Adult; D044466:Asian People / Q000706:statistics & numerical data*; D001706:Biopsy; D002681:China / Q000453:epidemiology; D005260:Female; D015433:Glomerulonephritis, Membranous / Q000150:complications / Q000208:ethnology* / Q000401:mortality / Q000473:pathology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000208:ethnology* / Q000209:etiology / Q000401:mortality / Q000473:pathology; D008297:Male; D016347:Medical Records Systems, Computerized; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors