Related Experiment Video

Updated: Feb 6, 2026

Mechanism of Kemeng Fang's Inhibition of Podocyte Apoptosis in Rats with Membranous Nephropathy through the PI3K/AKT Signaling Pathway
07:15

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

950

Clinical implications of pathological features of primary membranous nephropathy

Xiao-Dan Zhang1, Zhao Cui2, Mu-Fan Zhang1

  • 1Renal Division, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Peking University First Hospital, Institute of Nephrology, Peking University, Beijing, 100034, People's Republic of China.

BMC Nephrology
|August 30, 2018
PubMed
Abstract

Insights

Severe chronic tubulointerstitial injury in primary membranous nephropathy (pMN) is a significant risk factor for kidney failure. Kidney biopsy findings, particularly tubulointerstitial injury, are crucial for predicting prognosis in pMN patients.

Area of Science:

  • Nephrology
  • Pathology
  • Immunology

Background:

  • Primary membranous nephropathy (pMN) exhibits variable clinical outcomes.
  • Established risk factors for pMN prognosis include age, male gender, persistent proteinuria, reduced eGFR, and elevated anti-PLA2R antibodies.
  • The predictive value of histopathological features for treatment response and kidney outcomes in pMN remains debated.

Purpose of the Study:

  • To investigate the prognostic significance of histopathological parameters in patients with biopsy-proven primary membranous nephropathy (pMN).
  • To determine if specific kidney biopsy findings can predict treatment response and long-term kidney outcomes in pMN.

Main Methods:

  • A retrospective analysis of 371 patients with biopsy-proven pMN.
  • Evaluation of pathological parameters including immunofluorescence staining, membranous Churg's stages, sclerosis, crescents, focal segmental glomerulosclerosis, and chronic/acute tubulointerstitial injury.
  • Quantification of fluorescence intensity and grading of chronic tubulointerstitial injury based on the affected area.

Main Results:

  • Higher intensity of C3 staining, advanced membranous stage, and more severe chronic tubulointerstitial injury correlated with increased anti-PLA2R antibody positivity, higher proteinuria, elevated serum creatinine, and lower serum albumin.
  • Severe chronic tubulointerstitial injury (grade 3) was identified as a significant risk factor for end-stage kidney disease (ESKD) and a >50% reduction in estimated glomerular filtration rate (eGFR).
  • Multivariate analysis confirmed severe chronic tubulointerstitial injury as an independent risk factor for ESKD; no pathological parameters influenced treatment response.

Conclusions:

  • Chronic tubulointerstitial injury severity is a key prognostic indicator for kidney outcomes in primary membranous nephropathy (pMN).
  • Kidney biopsy remains valuable for diagnosis and prognosis, especially alongside anti-PLA2R antibody testing in pMN management.
  • Histopathological features, particularly tubulointerstitial changes, offer critical insights into the long-term prognosis of pMN.
Keywords:
Membranous nephropathyPathologyPrognosisTubulointerstitial injury

More Related Videos

Ex Vivo Treatment Response of Primary Tumors and/or Associated Metastases for Preclinical and Clinical Development of Therapeutics08:29

Ex Vivo Treatment Response of Primary Tumors and/or Associated Metastases for Preclinical and Clinical Development of Therapeutics

Published on: October 2, 2014

15.2K
Simple and Rapid Method to Obtain High-quality Tumor DNA from Clinical-pathological Specimens Using Touch Imprint Cytology11:20

Simple and Rapid Method to Obtain High-quality Tumor DNA from Clinical-pathological Specimens Using Touch Imprint Cytology

Published on: March 21, 2018

11.4K

Related Concept Videos

COPD: Pathogenesis and Clinical Features01:20

COPD: Pathogenesis and Clinical Features

Chronic obstructive pulmonary disease (COPD) is a group of lung conditions that progressively worsen over time, including chronic bronchitis and emphysema. This cluster of diseases collectively leads to a gradual and irreversible decline in lung function over time.
The primary cause for the onset of COPD is cigarette smoking and exposure to air pollution. These hazardous factors initiate a chain reaction within the lungs, resulting in chronic inflammation, damage to the airways, and a...
1.9K
Esophageal Strictures-II: Clinical Features and Management01:26

Esophageal Strictures-II: Clinical Features and Management

Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
665
Endocarditis II: Clinical Features of Infective Endocarditis01:25

Endocarditis II: Clinical Features of Infective Endocarditis

Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
528
Pericarditis II: Clinical Features and Diagnostic Tests01:19

Pericarditis II: Clinical Features and Diagnostic Tests

Pericarditis is distinguished by inflammation of the pericardium, the fibrous sac that encases the heart. It can be acute, lasting less than six weeks, or chronic, persisting for over three months. Understanding its clinical manifestations and diagnostic findings is crucial for timely and effective management.Clinical ManifestationsWhile pericarditis can be asymptomatic, it usually presents with characteristic symptoms such as:Chest Pain: The most characteristic symptom of pericarditis is chest...
333
Esophageal Varices-II: Clinical Features and Management01:28

Esophageal Varices-II: Clinical Features and Management

Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
588
Myocarditis II: Clinical Features and Diagnostic Tests01:27

Myocarditis II: Clinical Features and Diagnostic Tests

Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
328