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. 2024 Oct 24;25(1):377.
doi: 10.1186/s12882-024-03796-4.

Effects of immunosuppressive therapy on renal prognosis in primary membranous nephropathy

Wangyang Li #  1 , Ji Cen #  2 , Dongli Qi  1 , Mijie Guan  1 , Jia Chen  1 , Xun Qin  2 , Shengchun Wu  2 , Meifang Shang  2 , Lingqiao Wei  2 , Xinxu Lu  2 , Huiwei Huang  1 , Zhe Wei  3 , Qijun Wan  4 , Yuan Cheng  5
Affiliations

Effects of immunosuppressive therapy on renal prognosis in primary membranous nephropathy

Wangyang Li et al. BMC Nephrol. .

Abstract

Background: Immunosuppressive therapy plays a crucial role in treating membranous nephropathy, with previous studies highlighting its benefits for patients with primary membranous nephropathy (PMN). Guidelines suggest that the management of membranous nephropathy should be tailored to individual risk levels. However, there is a lack of real-world studies examining the effects of immunosuppressive therapy on renal outcomes in PMN patients. This study aimed to investigate the relationship between immunosuppressive therapy and renal prognosis in PMN patients.

Methods: This was a real-world retrospective study including patients diagnosed with PMN in Shenzhen Second People's Hospital and Hechi People's Hospital. Univariate and multivariate Cox regression analysis and Kaplan-Meier survival analysis were used.

Results: After propensity score-matching, 464 PMN patients were included and they were assigned to conservative and immunosuppressive group in a 1:1 ratio. Immunosuppressive therapy was the protective factor of renal composite outcome (HR = 0.65, p < 0.01). Separately, the effect was significant in moderate- and high-risk but not in low-risk patients. Key influencing factors including age, blood pressure, albumin and total cholesterol levels, with slight differences among patients at different risk.

Conclusions: This study demonstrates the efficacy of immunosuppressive therapy in non-low-risk PMN patients. The key factors affecting renal prognosis in patients with different risk levels are emphasized to help provide individualized treatment.

Keywords: Conservative therapy; Immunosuppressive therapy; Primary membranous nephropathy; Prognosis; Risk-based.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of the participants
Fig. 2
Fig. 2
Cumulative incidence of renal composite outcomes in total (A), low-risk (B), moderate-risk (C), and high-risk (D) patients
Fig. 3
Fig. 3
Subgroup analysis of immunosuppressive therapy on PMN patients. DM, diabetes mellitus; HTN, hypertension; Alb, albumin
See this image and copyright information in PMC

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