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Patients with primary membranous nephropathy are at high risk of cardiovascular events

Taewoo Lee1, Vimal K Derebail2, Abhijit V Kshirsagar2

  • 1UNC Kidney Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA; Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea.

Kidney International
|March 1, 2016
PubMed

Insights

Patients with primary membranous nephropathy face a high risk of cardiovascular events (CVEs), comparable to or exceeding end-stage renal disease (ESRD). Early intervention focusing on CVE reduction is crucial for managing this condition.

Area of Science:

  • Nephrology
  • Cardiology
  • Epidemiology

Background:

  • Primary membranous nephropathy (PMN) is a leading cause of nephrotic syndrome in adults.
  • Cardiovascular events (CVEs) and end-stage renal disease (ESRD) are significant complications in PMN patients.
  • The relative risk of CVEs versus ESRD in PMN requires further investigation.

Purpose of the Study:

  • To compare the risk of CVEs relative to ESRD in patients with PMN.
  • To identify risk factors for CVEs in this patient population.
  • To validate findings in an independent cohort.

Main Methods:

  • Retrospective study design using a discovery cohort (n=404) and a validation cohort (n=557).
  • Cumulative incidence of CVEs estimated considering the competing risk of ESRD.
  • Multivariable survival analysis employed to assess risk factors for CVEs.

Main Results:

  • Cumulative incidences of CVEs were 4.4%, 5.4%, 8.2%, and 8.8% at 1, 2, 3, and 5 years, respectively.
  • In the first two years, CVE risk was similar to ESRD risk overall, but higher in patients with preserved renal function.
  • Severity of nephrosis was a significant independent risk factor for CVEs (HR 2.1, 95% CI 1.1-4.3).

Conclusions:

  • Patients with PMN have an elevated risk of CVEs early in the disease course, often exceeding the risk of ESRD.
  • Reducing CVEs should be a primary therapeutic goal and outcome measure in PMN management.
  • The findings underscore the importance of cardiovascular risk assessment and intervention in PMN patients.

Keywords:
cardiovascular diseaseglomerulonephritismembranous nephropathy

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