ArticleHistopathology2019
Histological grading in primary membranous nephropathy is essential for clinical management and predicts outcome of patients.
Article in Histopathology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
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Who cites it
26 citing papers in PubMed, 35 citations in OpenAlex.
- Histopathological predictors of renal outcomes in idiopathic membranous nephropathy with a focus on global sclerotic glomeruli ratio.Scientific reports · 2026Article
- Prognostic Stratification in Primary Glomerulonephritis: Integrating Histology, Biomarkers, and Risk Prediction Models.Life (Basel, Switzerland) · 2026Review
- FSTIV score is essential for clinical management and predicts outcome of idiopathic membranous nephropathy.BMC nephrology · 2026Article
- Prognostic value of a composite histologic score in glomerular diseases: a 10-year single center cohort study.BMC nephrology · 2026Article
- Screening potential diagnostic biomarkers for PLA2R‑associated idiopathic membranous nephropathy by WGCNA analysis and LASSO algorithm.Renal failure · 2025Article
- Membranous nephropathy concurrent with renal amyloidosis: a six-patient report and literature review.Renal failure · 2025Review
- Renal tubulointerstitial lesions: a prognostic marker in idiopathic membranous nephropathy.Renal failure · 2025Article
- Laboratory, Clinical, and Pathohistological Significance of the Outcomes of Patients with Membranous Nephropathy After 10 Year of Follow-Up.Life (Basel, Switzerland) · 2025Article
- Clinicopathological characteristics of neural epidermal growth factor-like 1 protein-associated membranous glomerulonephritis.Virchows Archiv : an international journal of pathology · 2025Article
- Spontaneous remission in primary membranous nephropathy: mechanisms, predictive factors, and implications for personalized management.Frontiers in immunology · 2025Review
- Factors influencing early response of IgA nephropathy following targeted-release budesonide (TRB) treatment: preliminary results from a multicenter study.Clinical kidney journal · 2025Article
- SPP1 as a biomarker for idiopathic membranous nephropathy progression and its regulatory role in inflammation and fibrosis.Frontiers in immunology · 2025Article
- Article
- The prognostic value of two histopathologic classification models of ANCA-associated glomerulonephritis: a prospective study.Journal of nephrology · 2024Article
- Primary membranous nephropathy in the Italian region of Emilia Romagna: results of a multicenter study with extended follow-up.Journal of nephrology · 2024Article
- Mechanisms that potentially contribute to the development of post-streptococcal glomerulonephritis.Pathogens and disease · 2024Review
- Defining the threshold: triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio's non-linear impact on tubular atrophy in primary membranous nephropathy.Frontiers in endocrinology · 2024Article
- Clinicopathological features and outcome in elderly patients with idiopathic membranous nephropathy.Renal failure · 2023Article
- The application of podocyte antigen PLA2R and anti-PLA2R antibody in the diagnosis and treatment of membranous nephropathy.Renal failure · 2023Article
- Kidney diseases.Immunological reviews · 2023Review
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Authors and funding
43 authors at 20 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsDiagnosis of primary membranous nephropathy (PMN) is mainly based on immunofluorescence/immunohistochemistry findings. However, assessment of specific features on optical microscopy can help to estimate the severity of the disease, guide treatment and predict the response. The aim of this study was to identify, classify and grade the precise histological findings in PMN to predict renal function outcome and guide treatment. METHODS AND
resultsHistological parameters, including focal segmental sclerosis (FSGS), tubular atrophy (TA), interstitial fibrosis (IF) and vascular hyalinosis (VH), were re-evaluated in 752 patients with PMN. Their predictive value was estimated separately, and also in a combination score (FSTIV) graded from 0 to 4. Finally, the impact of histology was assessed in the response to immunosuppressive treatment. Mean age of patients was 53.3 (15-85) years and most presented with nephrotic syndrome. FSGS was present in 32% and VH in 51% of the patients, while TA and IF were graded as stage ≥1 in 52% and 51.4%, respectively. The follow-up period was 122.3 (112-376) months. FSGS, TA and IF and VH were associated with impaired renal function at diagnosis (P = 0.02, P < 0.0001, P = 0.001 and P = 0.02, respectively) and at the end of follow-up (P = 0.004, P < 0.0001, P < 0.0001 and P = 0.04, respectively). In multiple regression and binary logistic analysis, the presence of FSGS and degree of TA were the most significant parameters predicting renal function outcome, defined either by eGFR (end), FSGS (r = 0.6, P < 0.0001) and TA (r = 0.6, P < 0.0001), or by the endpoint of >50% eGFR reduction, FSGS (P = 0.001) and TA (P = 0.02). Also, patients presented with FSGS, IF, VH and/or with FSTIV > 1 could benefit from immunosuppression, regardless of clinical presentation.
conclusionsThe presence and degree of four histological indices, FSGS, VH, TA and IF, assessed separately or in combination, and FSTIV score not only predict renal function outcome after long-term follow-up, but can also help in the choice of appropriate treatment. Decisions concerning immunosuppressive treatment can be guided by pathology regardless of clinical findings.
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