Renal tubulointerstitial lesions: a prognostic marker in idiopathic membranous nephropathy

Objective To evaluate the impact of renal tubulointerstitial lesions (TIL) on clinical and pathologic outcomes and prognosis in patients with idiopathic membranous nephropathy.Methods A retrospective cohort study was performed on 582 patients with idiopathic membranous nephropathy. Patients were div...

Full description

Saved in:
Bibliographic Details
Main Authors: Yonghua Liu, Xiuhua Ma, Min Yu, Xiaoling Zhou
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Renal Failure
Subjects:
Online Access:https://www.tandfonline.com/doi/10.1080/0886022X.2025.2501379
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850153131096145920
author Yonghua Liu
Xiuhua Ma
Min Yu
Xiaoling Zhou
author_facet Yonghua Liu
Xiuhua Ma
Min Yu
Xiaoling Zhou
author_sort Yonghua Liu
collection DOAJ
description Objective To evaluate the impact of renal tubulointerstitial lesions (TIL) on clinical and pathologic outcomes and prognosis in patients with idiopathic membranous nephropathy.Methods A retrospective cohort study was performed on 582 patients with idiopathic membranous nephropathy. Patients were divided into two groups based on the presence or absence of TIL as determined by renal biopsy: TIL– (258 cases) and TIL+ (324 cases). Kaplan-Meier survival curves and Cox regression models were used to analyze the influence of TIL on renal prognosis. Logistic regression models were used to further identify risk factors associated with the development of TIL.Results Patients in the TIL+ group were predominantly male, older, and had a higher prevalence of hypertension, hyperlipidemia, nephrotic syndrome, microscopic hematuria, and immunosuppressive therapy compared to the TIL– group. In addition, triglycerides, blood urea nitrogen, and 24-hour urine protein were significantly higher in the TIL+ group, while albumin and estimated glomerular filtration rate were lower (p < 0.05). Pathologic staging revealed more severe glomerulosclerosis lesions and renal artery intimal thickening in the TIL+ group. After a median follow-up of 45 months, IMN patients in the TIL+ group had a lower disease remission rate and worse renal prognosis as demonstrated by Kaplan-Meier survival curves and Cox regression modeling. Logistic regression modeling identified hypertension, globular/segmental glomerulosclerosis, and intimal thickening of small renal arteries as independent risk factors for TIL in patients with idiopathic membranous nephropathy.Conclusion TIL is frequently associated with idiopathic membranous nephropathy, with more severe clinical manifestations and pathologic features, and idiopathic membranous nephropathy patients with TIL have a lower disease remission rate and worse overall renal prognosis. Hypertension, globular/segmental glomerulosclerosis, and intimal thickening of small renal arteries are independent risk factors for the development of TIL in patients with idiopathic membranous nephropathy.
format Article
id doaj-art-af9cb156d01440b28d764bc29e9e1150
institution OA Journals
issn 0886-022X
1525-6049
language English
publishDate 2025-12-01
publisher Taylor & Francis Group
record_format Article
series Renal Failure
spelling doaj-art-af9cb156d01440b28d764bc29e9e11502025-08-20T02:25:48ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492025-12-0147110.1080/0886022X.2025.2501379Renal tubulointerstitial lesions: a prognostic marker in idiopathic membranous nephropathyYonghua Liu0Xiuhua Ma1Min Yu2Xiaoling Zhou3Department of Nephrology, General Hospital of Ningxia Medical University, Yinchuan, ChinaDepartment of Nephrology, General Hospital of Ningxia Medical University, Yinchuan, ChinaDepartment of Nephrology, General Hospital of Ningxia Medical University, Yinchuan, ChinaDepartment of Nephrology, General Hospital of Ningxia Medical University, Yinchuan, ChinaObjective To evaluate the impact of renal tubulointerstitial lesions (TIL) on clinical and pathologic outcomes and prognosis in patients with idiopathic membranous nephropathy.Methods A retrospective cohort study was performed on 582 patients with idiopathic membranous nephropathy. Patients were divided into two groups based on the presence or absence of TIL as determined by renal biopsy: TIL– (258 cases) and TIL+ (324 cases). Kaplan-Meier survival curves and Cox regression models were used to analyze the influence of TIL on renal prognosis. Logistic regression models were used to further identify risk factors associated with the development of TIL.Results Patients in the TIL+ group were predominantly male, older, and had a higher prevalence of hypertension, hyperlipidemia, nephrotic syndrome, microscopic hematuria, and immunosuppressive therapy compared to the TIL– group. In addition, triglycerides, blood urea nitrogen, and 24-hour urine protein were significantly higher in the TIL+ group, while albumin and estimated glomerular filtration rate were lower (p < 0.05). Pathologic staging revealed more severe glomerulosclerosis lesions and renal artery intimal thickening in the TIL+ group. After a median follow-up of 45 months, IMN patients in the TIL+ group had a lower disease remission rate and worse renal prognosis as demonstrated by Kaplan-Meier survival curves and Cox regression modeling. Logistic regression modeling identified hypertension, globular/segmental glomerulosclerosis, and intimal thickening of small renal arteries as independent risk factors for TIL in patients with idiopathic membranous nephropathy.Conclusion TIL is frequently associated with idiopathic membranous nephropathy, with more severe clinical manifestations and pathologic features, and idiopathic membranous nephropathy patients with TIL have a lower disease remission rate and worse overall renal prognosis. Hypertension, globular/segmental glomerulosclerosis, and intimal thickening of small renal arteries are independent risk factors for the development of TIL in patients with idiopathic membranous nephropathy.https://www.tandfonline.com/doi/10.1080/0886022X.2025.2501379Idiopathic membranous nephropathyrenal tubulointerstitial lesionsclinicopathologicalprognosis
spellingShingle Yonghua Liu
Xiuhua Ma
Min Yu
Xiaoling Zhou
Renal tubulointerstitial lesions: a prognostic marker in idiopathic membranous nephropathy
Renal Failure
Idiopathic membranous nephropathy
renal tubulointerstitial lesions
clinicopathological
prognosis
title Renal tubulointerstitial lesions: a prognostic marker in idiopathic membranous nephropathy
title_full Renal tubulointerstitial lesions: a prognostic marker in idiopathic membranous nephropathy
title_fullStr Renal tubulointerstitial lesions: a prognostic marker in idiopathic membranous nephropathy
title_full_unstemmed Renal tubulointerstitial lesions: a prognostic marker in idiopathic membranous nephropathy
title_short Renal tubulointerstitial lesions: a prognostic marker in idiopathic membranous nephropathy
title_sort renal tubulointerstitial lesions a prognostic marker in idiopathic membranous nephropathy
topic Idiopathic membranous nephropathy
renal tubulointerstitial lesions
clinicopathological
prognosis
url https://www.tandfonline.com/doi/10.1080/0886022X.2025.2501379
work_keys_str_mv AT yonghualiu renaltubulointerstitiallesionsaprognosticmarkerinidiopathicmembranousnephropathy
AT xiuhuama renaltubulointerstitiallesionsaprognosticmarkerinidiopathicmembranousnephropathy
AT minyu renaltubulointerstitiallesionsaprognosticmarkerinidiopathicmembranousnephropathy
AT xiaolingzhou renaltubulointerstitiallesionsaprognosticmarkerinidiopathicmembranousnephropathy