Acute kidney injury in patients with idiopathic membranous nephropathy: influencing factors and prognosis

Abstract

Aim

Idiopathic membranous nephropathy (IMN) is a common type of nephrotic syndrome, and is associated with acute kidney injury (AKI). We investigated the association of multiple variables with AKI in patients with IMN.

Methods

The data of 187 patients with biopsy-proven IMN were examined. Renal outcome was defined as progression to end-stage renal disease (ESRD). Binary logistic regression and Kaplan–Meier’s analysis were used for statistical analysis.

Results

During follow-up, 46 (24.6%) patients developed AKI. The incidence of AKI was greater in males than females (p < .01). The AKI group had higher uric acid, lower serum PLA2R antibody positive, and worse baseline kidney function (all p < .01). Most patients in the AKI group had stage I (71.74%) or stage II (21.74%). The AKI group had higher renal tubular injury score and chronicity index (both p < .05). Binary logistic regression indicated that uric acid and baseline estimated glomerular filtration rate (eGFR) were independent risk factors for AKI in patients with IMN (p < .05). The optimal cutoff value of serum uric acid for predicting AKI was 402.50 μmol/L and the baseline eGFR was 96.83 mL/min/1.73 m². Kaplan–Meier’s analysis showed that the cumulative renal survival rate was lower in the AKI group (p = .047).

Conclusions

AKI increases the risk of poor prognosis in IMN patients and the high uric acid and low baseline eGFR were considered independent predictors for developing AKI in patients with IMN.

Keywords:

• Acute kidney injury
• idiopathic membranous nephropathy
• biopsy
• prognosis

Author contributions

Study design and data collection: ZZL, MJW, JQL, and JXW. Case contributor: DWJ, YC, BBF, GFL, CMC, YFX, JC, and JXW. Analysis data: MJW, LZL, JC, and JXW. Writing the manuscript: ZZL and JXW.

Consent form

Informed consent approved by local ethical committee has been obtained from each participant after full explanation of the purpose and nature of all procedures used.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was funded by Fujian Provincial Science and Technology Plan Project [Grant Number: 2021Y2005].