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. 2025 Jan;44(1):79-90.
doi: 10.23876/j.krcp.23.159. Epub 2024 Feb 15.

Comparison between characteristics of immunoglobulin M nephropathy and other glomerular diseases

Giae Yun  1 , Eun Jeong Kwon  1 , Seokwoo Park  1 , Jong Cheol Jeong  1   2 , Sejoong Kim  1 , Ki Young Na  1   2 , Ho Jun Chin  1   2
Affiliations

Comparison between characteristics of immunoglobulin M nephropathy and other glomerular diseases

Giae Yun et al. Kidney Res Clin Pract. 2025 Jan.

Abstract

Background: Immunoglobulin M (IgM) nephropathy (IgMN) is characterized by the IgM deposition in the kidney's mesangium. We assessed the impact of electron-dense deposits (EDDs) on IgMN and compared it to other kidney diseases.

Methods: We enrolled 63 adult patients with IgMN who underwent renal biopsy from May 2003 to June 2017. We compared clinicopathological features of IgMN based on EDD presence; compared characteristics to 91 minimal change disease (MCD), 103 focal segmental glomerulosclerosis (FSGS), and 469 immunoglobulin A nephropathy (IgAN) patients. Renal events were defined as a >50% decrease in estimated glomerular filtration rate (eGFR), eGFR of <15 mL/min/1.73 m2, or end-stage renal disease development.

Results: IgMN patients with EDDs had increased mesangial cellularity, matrix accumulation, prominent immunofluorescent staining, and more diffuse podocyte effacement than those without EDD. Clinical characteristics and renal outcomes did not differ significantly based on EDD presence. During 79.5 ± 58.8 months of follow-up, renal events developed in 46.2% and 46.0% of IgMN cases with and without EDD. IgMN (46.0%) and FSGS cases (40.8%) had similar frequencies of renal events and higher frequency than MCD (18.7%) or IgAN cases (26.4%). IgMN cases had more severe manifestations than MCD and IgAN; higher blood pressure, lower proteinuria, and eGFR levels at biopsy than MCD cases; higher blood pressure, proteinuria, frequency of acute kidney injury, and lower eGFR levels.

Conclusion: Clinical characteristics of IgMN did not differ based on EDD presence. Therefore, IgMN should be defined based on IF findings. IgMN shared clinical characteristics with FSGS but had more severe than MCD and IgAN.

Keywords: Biopsy; Glomerulonephritis; Immunoglobulin A; Immunoglobulin M; Proteinuria.

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Conflict of interest statement

Conflicts of interest

All authors have no conflicts of interest to declare.

Figures

Figure 1.
Figure 1.. Renal event-free survival rate of patients with immunoglobulin M nephropathy according to the presence of electron-dense deposits on mesangium.
Renal event: any event of estimated glomerular filtration rate (eGFR) <15 mL/min/1.73 m2, end-stage renal disease requiring renal replacement therapy, or eGFR 50% or more of the value at renal biopsy during the follow-up period. EDD, patients with electron-dense deposits on mesangium; No-EDD, patients without electron-dense deposits on mesangium.
Figure 2.
Figure 2.. Renal event-free survival rate of patients with MCD, FSGS, IgAN, and IgMN.
Renal event: any event of estimated glomerular filtration rate (eGFR) <15 mL/min/1.73 m2, end-stage renal disease requiring renal replacement therapy, or eGFR 50% or more of the value at renal biopsy during the follow-up period. FSGS, focal segmental glomerulosclerosis; Ig, immunoglobulin; IgAN, IgA nephropathy; IgMN, IgM nephropathy. MCD, minimal change disease.
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References

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