Acute kidney injury in patients with idiopathic membranous nephropathy: influencing factors and prognosis

Li, Zhenzhou; Weng, Mengjie; Lin, Lizhao; Chen, Yi; Lin, Jiaqun; Cui, Jiong; De-wen, Jiang; Fu, Bin-Bin; Li, Guifen; Chen, Caiming; Wan, Jianxin

doi:10.1080/0886022x.2023.2194451

Cited by 3 publications

(1 citation statement)

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“…Patients with pMN have varying degrees of proteinuria, from mild to severe, and some patients present with acute kidney injury. [ 18 , 19 ]. Since FETP is tightly associated with proteinuria and creatinine kinetics, it may accurately reflect the disruption of glomerular filtration barrier and may be a stronger predictor of renal prognosis in patients with pMN.…”

Section: Introductionmentioning

confidence: 99%

Fractional excretion of total protein predicts renal prognosis in Japanese patients with primary membranous nephropathy

Kuno,

Kanzaki,

Sasaki

et al. 2024

Clinical Kidney Journal

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Background Primary membranous nephropathy (pMN) is one of the most common types of glomerulonephritis, with a third of patients progressing to renal insufficiency. Various prognostic factors have been reported, of which urinary protein and renal function are the most critical parameters. Fractional excretion of total protein (FETP) indicates protein leakage that accounts for creatinine kinetics and serum protein levels. In this study, we investigated the association between FETP and renal prognosis in pMN. Methods We retrospectively identified 150 patients with pMN. FETP was calculated as follows: (serum creatinine × urine protein)/(serum protein × urine creatinine) %. We divided the patients into three groups according to FETP values and compared the clinicopathological findings. The primary outcome was an estimated glomerular filtration rate (eGFR) decrease of ≥ 30% from the baseline level. Results FETP was associated with urinary protein and renal function, Ehrenreich and Churg stage, and global glomerulosclerosis. The primary outcome was observed in 38 patients (25.3%), and the frequency of the primary outcome was higher in the higher FETP group (P = 0.001). FETP is higher than protein–creatinine ratio (PCR) in the area under the curve. In the multivariate analysis adjusted for age, eGFR, PCR, and treatment, FETP was significantly associated with primary outcome (adjusted hazard ratio, 8.19; P < 0.019). Conclusions FETP is a valuable indicator that can reflect the pathophysiology and is more useful than PCR as a predictor of renal prognosis in patients with Japanese pMN.

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Section: Introductionmentioning

confidence: 99%