Renal arteriolosclerosis impact on clinicopathological features and outcomes of idiopathic membranous nephropathy: a retrospective cohort analysis
BackgroundTo investigate the clinicopathological features and prognostic factors of idiopathic membranous nephropathy (IMN) patients with renal arteriolosclerosis, providing evidence for individualized clinical management.MethodsA retrospective analysis was conducted on 597 biopsy-confirmed IMN pati...
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Frontiers Media S.A.
2025-05-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2025.1594990/full |
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| author | Rui Jiang Li Li Yunfei Yan Hucai Li Ruizhi Yu Yang Huang Lixin Wang |
| author_facet | Rui Jiang Li Li Yunfei Yan Hucai Li Ruizhi Yu Yang Huang Lixin Wang |
| author_sort | Rui Jiang |
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| description | BackgroundTo investigate the clinicopathological features and prognostic factors of idiopathic membranous nephropathy (IMN) patients with renal arteriolosclerosis, providing evidence for individualized clinical management.MethodsA retrospective analysis was conducted on 597 biopsy-confirmed IMN patients at Guangdong Provincial Hospital of Chinese Medicine from January 1, 2012, to December 31, 2022. Patients were stratified into two groups based on the presence of renal arteriolosclerosis. Clinical and pathological characteristics were compared between groups. Kaplan–Meier curves were used to assess cumulative renal remission rates, and Cox regression analysis was performed to identify risk factors for composite endpoint events in IMN patients with arteriolosclerosis.ResultsIn a cohort of 597 IMN patients (55.6% male), significant baseline differences were observed in Serum Sodium, triglycerides, membranous nephropathy (MN) stage, mesangial proliferation, interstitial fibrosis, and IgG deposition between the arteriolosclerosis and non-arteriolosclerosis groups (p < 0.05). Kaplan–Meier analysis demonstrated markedly lower renal survival in the arteriolosclerosis group (Log-rank χ2 = 8.296, p = 0.004). Multivariate Cox regression identified age (HR = 1.022, 95% CI 1.003–1.042; p = 0.022), serum creatinine (SCr) (HR = 1.010, 95% CI 1.002–1.018; p = 0.017), IgM 3 + deposition (HR = 4.718, 95% CI 1.003–1.042; p < 0.001), and interstitial fibrosis (HR > 1, p < 0.05) as independent risk factors for composite endpoint events, Compared to their respective reference groups, C1q (3+) and tubular atrophy (≥50%) have a protective effect against adverse renal outcomes (HR < 1, p < 0.05).ConclusionRenal arteriolosclerosis portends poorer prognosis in IMN, with distinct clinicopathological features and accelerated renal function decline. Age, elevated creatinine, intense immune complex deposition, and advanced tubular-interstitial damage represent critical risk markers, highlighting the need for early vascular assessment and histology-guided risk stratification in this population. |
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| institution | OA Journals |
| issn | 2296-858X |
| language | English |
| publishDate | 2025-05-01 |
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| spelling | doaj-art-dde83224bfa9418bb9b940c9afb915dc2025-08-20T01:55:22ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-05-011210.3389/fmed.2025.15949901594990Renal arteriolosclerosis impact on clinicopathological features and outcomes of idiopathic membranous nephropathy: a retrospective cohort analysisRui Jiang0Li Li1Yunfei Yan2Hucai Li3Ruizhi Yu4Yang Huang5Lixin Wang6The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, ChinaThe Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, ChinaThe Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, ChinaDepartment of Nephrology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, ChinaThe Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, ChinaThe Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, ChinaDepartment of Nephrology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, ChinaBackgroundTo investigate the clinicopathological features and prognostic factors of idiopathic membranous nephropathy (IMN) patients with renal arteriolosclerosis, providing evidence for individualized clinical management.MethodsA retrospective analysis was conducted on 597 biopsy-confirmed IMN patients at Guangdong Provincial Hospital of Chinese Medicine from January 1, 2012, to December 31, 2022. Patients were stratified into two groups based on the presence of renal arteriolosclerosis. Clinical and pathological characteristics were compared between groups. Kaplan–Meier curves were used to assess cumulative renal remission rates, and Cox regression analysis was performed to identify risk factors for composite endpoint events in IMN patients with arteriolosclerosis.ResultsIn a cohort of 597 IMN patients (55.6% male), significant baseline differences were observed in Serum Sodium, triglycerides, membranous nephropathy (MN) stage, mesangial proliferation, interstitial fibrosis, and IgG deposition between the arteriolosclerosis and non-arteriolosclerosis groups (p < 0.05). Kaplan–Meier analysis demonstrated markedly lower renal survival in the arteriolosclerosis group (Log-rank χ2 = 8.296, p = 0.004). Multivariate Cox regression identified age (HR = 1.022, 95% CI 1.003–1.042; p = 0.022), serum creatinine (SCr) (HR = 1.010, 95% CI 1.002–1.018; p = 0.017), IgM 3 + deposition (HR = 4.718, 95% CI 1.003–1.042; p < 0.001), and interstitial fibrosis (HR > 1, p < 0.05) as independent risk factors for composite endpoint events, Compared to their respective reference groups, C1q (3+) and tubular atrophy (≥50%) have a protective effect against adverse renal outcomes (HR < 1, p < 0.05).ConclusionRenal arteriolosclerosis portends poorer prognosis in IMN, with distinct clinicopathological features and accelerated renal function decline. Age, elevated creatinine, intense immune complex deposition, and advanced tubular-interstitial damage represent critical risk markers, highlighting the need for early vascular assessment and histology-guided risk stratification in this population.https://www.frontiersin.org/articles/10.3389/fmed.2025.1594990/fullidiopathic membranous nephropathyarteriolar nephrosclerosis lesionrenal arteriolosclerosisclinicopathologicprognosis |
| spellingShingle | Rui Jiang Li Li Yunfei Yan Hucai Li Ruizhi Yu Yang Huang Lixin Wang Renal arteriolosclerosis impact on clinicopathological features and outcomes of idiopathic membranous nephropathy: a retrospective cohort analysis Frontiers in Medicine idiopathic membranous nephropathy arteriolar nephrosclerosis lesion renal arteriolosclerosis clinicopathologic prognosis |
| title | Renal arteriolosclerosis impact on clinicopathological features and outcomes of idiopathic membranous nephropathy: a retrospective cohort analysis |
| title_full | Renal arteriolosclerosis impact on clinicopathological features and outcomes of idiopathic membranous nephropathy: a retrospective cohort analysis |
| title_fullStr | Renal arteriolosclerosis impact on clinicopathological features and outcomes of idiopathic membranous nephropathy: a retrospective cohort analysis |
| title_full_unstemmed | Renal arteriolosclerosis impact on clinicopathological features and outcomes of idiopathic membranous nephropathy: a retrospective cohort analysis |
| title_short | Renal arteriolosclerosis impact on clinicopathological features and outcomes of idiopathic membranous nephropathy: a retrospective cohort analysis |
| title_sort | renal arteriolosclerosis impact on clinicopathological features and outcomes of idiopathic membranous nephropathy a retrospective cohort analysis |
| topic | idiopathic membranous nephropathy arteriolar nephrosclerosis lesion renal arteriolosclerosis clinicopathologic prognosis |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2025.1594990/full |
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