A nomogram for the prediction of renal outcomes among patients with idiopathic membranous nephropathy

Zhang,Ji; Pan,Shufang; Li,Duo; Li,Zhanyuan; Jin,Lingwei; Zhou,Zhihong; Pan,Min

doi:10.3892/etm.2020.9063

A nomogram for the prediction of renal outcomes among patients with idiopathic membranous nephropathy

Authors:
- Ji Zhang
- Shufang Pan
- Duo Li
- Zhanyuan Li
- Lingwei Jin
- Zhihong Zhou
- Min Pan
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Affiliations: Department of Nephrology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China, Department of Nephrology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
Published online on: July 28, 2020 https://doi.org/10.3892/etm.2020.9063
Pages: 3130-3137
Copyright: © Zhang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The early prediction of renal outcomes in patients with idiopathic membranous nephropathy (iMN) remains challenging. The present retrospective study evaluated patients with iMN confirmed by renal biopsy. An optimized Cox regression model and a nomogram were constructed for the early prediction of renal outcomes. A total of 141 patients who met the inclusion criteria were evaluated in the present study. In total 18 (12.8%) patients eventually progressed to the endpoint, 6 of whom developed end‑stage renal disease, and one patient died during follow‑up. The optimized model demonstrated that 24‑h proteinuria [hazard ratio (HR) 1.24; 95% CI, 1.10‑1.40; P‑value <0.001] and chronic tubulointerstitial injury [referred to as grade 0, grade 1 (HR), 5.12; 95% CI, 1.33‑19.75; P‑value=0.02] or grade 2 (HR, 6.43; 95% CI, 1.35‑30.59; P‑value=0.02) were independent risk factors for a poor renal outcome. Patients with an estimated three‑year renal survival rate (ETR) less than 0.87 had a high risk of a poor renal outcome. In addition, patients with an ETR of 0.87 to 0.98 more quickly developed a decreased estimated glomerular filtration rate after two years of follow‑up. In the present study a nomogram for the early prediction of renal outcomes in patients with iMN was developed. This nonogram suggested that patients with an ETR of 0.87‑0.98 should receive greater attention during follow‑up.

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