Related Experiment Video
Updated: Apr 27, 2026
Mechanism of Kemeng Fang's Inhibition of Podocyte Apoptosis in Rats with Membranous Nephropathy through the PI3K/AKT Signaling Pathway
Published on: August 23, 2024
Relapse and its remission in Japanese patients with idiopathic membranous nephropathy
Shinji Kitajima1, Kengo Furuichi, Norihiko Sakai
1Division of Nephrology, Kanazawa University Hospital, Kanazawa, Japan.
Background:
The prognosis in patients with idiopathic membranous nephropathy (IMN) is diverse. However, the prognosis after relapse and factors affecting relapse remain unclear.
Methods:
A total of 146 Japanese patients with IMN who had been followed up for at least 3 years, or until end-stage renal failure or death were enrolled in this retrospective study. The initial clinicopathological factors were examined between the patients with and without relapse. The patients were assigned to two groups based on the electron microscopic findings: homogeneous type with synchronous electron-dense deposits and heterogeneous type with various phases of dense deposits.
Results:
A total of 105 of the 146 patients (72 %) achieved complete remission (CR) or incomplete remission (ICR) I after initial treatment. Twenty-six of the 105 patients relapsed after CR or ICR I (25 %). There were no differences in initial clinical findings or data between the patients with and without relapse, except for the higher degree of proteinuria at onset in patients with relapse. The relapse rate of the heterogeneous group (43 %) was higher than that in the homogeneous group (20 %). There were no significant associations between relapse rate and immunosuppressive therapy at onset. Eleven of 26 patients showing relapse (42 %) achieved CR or ICR I, which was lower than the rate for patients with initial remission.
Conclusion:
Our results suggest that patients with relapse achieved CR or ICR I and that electron microscopic findings demonstrating heterogeneous type indicated susceptibility to relapse.
Insights
Idiopathic membranous nephropathy (IMN) patients with heterogeneous electron microscopic findings are more prone to relapse. Relapse in IMN patients can still lead to remission, but at a lower rate than initial treatment.
Area of Science:
- Nephrology
- Pathology
- Immunology
Background:
- Prognosis for idiopathic membranous nephropathy (IMN) varies.
- Factors influencing relapse and prognosis after relapse in IMN remain unclear.
Purpose of the Study:
- To investigate clinicopathological factors associated with relapse in Japanese patients with IMN.
- To identify predictors of relapse and remission outcomes after relapse in IMN.
Main Methods:
- Retrospective study of 146 Japanese IMN patients followed for at least 3 years.
- Analysis of initial clinicopathological factors and electron microscopic findings (homogeneous vs. heterogeneous types).
- Comparison of relapse rates and remission outcomes between different patient groups.
Main Results:
- 72% of patients achieved remission after initial treatment; 25% of those in remission relapsed.
- Higher proteinuria at onset was associated with relapse; heterogeneous type showed a higher relapse rate (43%) than homogeneous type (20%).
- Relapse did not correlate with initial immunosuppressive therapy; remission rates after relapse were lower than initial remission rates.
Conclusions:
- Heterogeneous electron microscopic findings in IMN indicate a higher susceptibility to relapse.
- Patients who relapse after initial remission can still achieve remission, albeit with a reduced success rate.
Related Concept Videos
01:29Acute Kidney Injury III: Clinical Manifestations
01:26Nephrotic Syndrome II : Assessment and Medical Management
01:24Nephrotic Syndrome I : Introduction
01:24Nephrotic Syndrome III : Nursing Management
01:24Chronic Kidney Disease II: Clinical Manifestations
01:29Acute Kidney Injury II: Pathophysiology