Age-adjusted global glomerulosclerosis and kidney outcomes in primary membranous nephropathy

Age-adjusted global glomerulosclerosis and kidney outcomes in primary membranous nephropathy. Download PDF Abstract Primary membranous nephropathy (PMN) is common in older adults, but age-related pathological changes have not been adequately considered in PMN. This study aimed to evaluate the association between age-adjusted globally sclerotic glomeruli (GSG) and kidney disease progression and remission in patients with PMN.

Two-hundred twenty patients with biopsy-proven PMN were included at seven hospitals between 2015 and 2024 and categorized into three groups based on age-based thresholds of GSG. During a median follow-up of 31.3 months, kidney disease progression occurred in 59 patients (26.8%). Complete remission and overall remission were achieved in 138 (62.7%) and 190 patients (86.4%), respectively.

In the multivariable Cox regression analysis, GSG abnormal for age was independently associated with an increased risk of kidney disease progression compared with no GSG (hazard ratio [HR] 2.12; 95% confidence interval [CI] 1.02–4.44; P = 0.046), whereas GSG normal for age was not (HR 0.67; 95% CI 0.35–1.31; P = 0.241). This association was no longer significant after severity-based adjustment for other chronic histologic lesions. After adjusting for confounding factors, GSG normal for age was associated with a higher rate of achieving overall remission than no GSG (HR 1.47; 95% CI 1.01–2.17; P = 0.049), but GSG abnormal for age was not (HR 0.98; 95% CI 0.57–1.68; P = 0.936).

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