Observational studyJournal of the American Society of Nephrology : JASN2020
Ultrastructural Characterization of Proteinuric Patients Predicts Clinical Outcomes.
Observational study in Journal of the American Society of Nephrology : JASN, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
25 citing papers in PubMed, 44 citations in OpenAlex.
- The endothelium response to kidney injury.Nature reviews. Nephrology · 2026Review
- Thickening of Glomerular Basement Membrane Is Associated with Long-Term Prognosis in Patients with IgA Nephropathy.Kidney360 · 2026Article
- Autoantibodies reactive with glomerular endothelial cells and podocytes in patients with membranous nephropathy.Journal of translational autoimmunity · 2026Article
- Glomerular Transcriptome Analysis Reveals Endothelial Disturbances in Patients With Idiopathic Nephrotic Syndrome.Kidney medicine · 2026Article
- Endothelial cell-released CD93 contributes to podocyte injury in idiopathic nephrotic syndrome.Science translational medicine · 2026Article
- Serum Syndecan-1 is Associated With Kidney and Cardiovascular Outcomes in Idiopathic Nephrotic Syndrome.Kidney international reports · 2025Article
- Diagnostic value of the correlation between urinary MDM2 and podocyte mitotic catastrophe in diabetic kidney disease.Diabetology & metabolic syndrome · 2025Article
- To biopsy or not to biopsy a teenager with idiopathic nephrotic syndrome? Biopsy first.Pediatric nephrology (Berlin, Germany) · 2025Article
- Modeling a biofluid-derived extracellular vesicle surface signature to differentiate pediatric idiopathic nephrotic syndrome clinical subgroups.Scientific reports · 2024Article
- Rationale and design of the Nephrotic Syndrome Study Network (NEPTUNE) Match in glomerular diseases: designing the right trial for the right patient, today.Kidney international · 2024Article
- Reproducibility of Rejection Grading in Uterus Transplantation: A Multicenter Study.Transplantation direct · 2023Article
- Epidemiology and clinicopathological characteristics of native kidney disease in children in Flanders, Belgium.Pediatric nephrology (Berlin, Germany) · 2023Article
- Role of detached podocytes in differentiating between minimal change disease and early focal segmental glomerulosclerosis, can we rely on routine light microscopy?Journal of nephrology · 2022Article
- Quantification of Glomerular Structural Lesions: Associations With Clinical Outcomes and Transcriptomic Profiles in Nephrotic Syndrome.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2022Observational
- Minimal Change Disease Is Associated With Endothelial Glycocalyx Degradation and Endothelial Activation.Kidney international reports · 2022Article
- Impact of Consensus Definitions on Identification of Glomerular Lesions by Light and Electron Microscopy.Kidney international reports · 2022Article
- The Pathology Lesion Patterns of Podocytopathies: How and why?Frontiers in cell and developmental biology · 2022Review
- Study on the relationship between nephrotic syndrome and atopic diseases in childhood.Frontiers in pediatrics · 2022Article
- De novo Glomerular Disease and the Significance of Electron Microscopy in Renal Transplantation.Glomerular diseases · 2021Review
- The Role of Glomerular Epithelial Injury in Kidney Function Decline in Patients With Diabetic Kidney Disease in the TRIDENT Cohort.Kidney international reports · 2021Article
Corrections and comments
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Authors and funding
12 authors at 7 institutions in 2 countries.
Funding
Abstract
backgroundThe analysis and reporting of glomerular features ascertained by electron microscopy are limited to few parameters with minimal predictive value, despite some contributions to disease diagnoses.
methodsWe investigated the prognostic value of 12 electron microscopy histologic and ultrastructural changes (descriptors) from the Nephrotic Syndrome Study Network (NEPTUNE) Digital Pathology Scoring System. Study pathologists scored 12 descriptors in NEPTUNE renal biopsies from 242 patients with minimal change disease or FSGS, with duplicate readings to evaluate reproducibility. We performed consensus clustering of patients to identify unique electron microscopy profiles. For both individual descriptors and clusters, we used Cox regression models to assess associations with time from biopsy to proteinuria remission and time to a composite progression outcome (≥40% decline in eGFR, with eGFR<60 ml/min per 1.73 m
resultsIntrarater and interrater reproducibility was >0.60 for 12 out of 12 and seven out of 12 descriptors, respectively. Individual podocyte descriptors such as effacement and microvillous transformation were associated with complete remission, whereas endothelial cell and glomerular basement membrane abnormalities were associated with progression. We identified six descriptor-based clusters with distinct electron microscopy profiles and clinical outcomes. Patients in a cluster with more prominent foot process effacement and microvillous transformation had the highest rates of complete proteinuria remission, whereas patients in clusters with extensive loss of primary processes and endothelial cell damage had the highest rates of the composite progression outcome.
conclusionsSystematic analysis of electron microscopic findings reveals clusters of findings associated with either proteinuria remission or disease progression.
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