Idiopathic membranous nephropathy: Definition and relevance of a partial remission
Idiopathic membranous nephropathy: Definition and relevance of a partial remission Membranous nephropathy (MGN) remains the most common cause of adult onset nephrotic syndrome, and within the primary glomerulonephritis group is a leading cause of renal failure. A complete remission (CR) confers an e...
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| Veröffentlicht in: | Kidney international 2004-09, Vol.66 (3), p.1199-1205 |
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| description | Idiopathic membranous nephropathy: Definition and relevance of a partial remission
Membranous nephropathy (MGN) remains the most common cause of adult onset nephrotic syndrome, and within the primary glomerulonephritis group is a leading cause of renal failure. A complete remission (CR) confers an excellent long-term prognosis, but the quantitative benefits of partial remissions (PR) have not been defined.
This study evaluated the rate of renal function decline (slope), relapse, and renal survival in nephrotic MGN patients with CR, PR, or no remission (NR). Multivariate analysis included clinical and laboratory data at presentation and over follow-up, blood pressure control and agents employed, and immunosuppressive therapy.
The study cohort consisted of 348 nephrotic MGN patients with a minimum of 12 months follow-up identified from the Toronto Glomerulonephritis Registry. Over a median follow-up of 60 months, 102 experienced a CR, 136 had a PR, and 110 had no remission. A PR was independently predictive of slope and survival from renal failure by multivariate analysis (hazard ratio 0.08, 95%CI 0.03–0.19, P < 0.001). Benefit from immunosuppression could only be shown in a subset of high-risk patients. Treatment-related PR had the same long-term implication as spontaneous ones. Relapses from PR were high (47%) but often reversible.
A partial remission is an important therapeutic target with implications for both progression rate and renal survival. |
| doi_str_mv | 10.1111/j.1523-1755.2004.00873.x |
| format | Article |
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Membranous nephropathy (MGN) remains the most common cause of adult onset nephrotic syndrome, and within the primary glomerulonephritis group is a leading cause of renal failure. A complete remission (CR) confers an excellent long-term prognosis, but the quantitative benefits of partial remissions (PR) have not been defined.
This study evaluated the rate of renal function decline (slope), relapse, and renal survival in nephrotic MGN patients with CR, PR, or no remission (NR). Multivariate analysis included clinical and laboratory data at presentation and over follow-up, blood pressure control and agents employed, and immunosuppressive therapy.
The study cohort consisted of 348 nephrotic MGN patients with a minimum of 12 months follow-up identified from the Toronto Glomerulonephritis Registry. Over a median follow-up of 60 months, 102 experienced a CR, 136 had a PR, and 110 had no remission. A PR was independently predictive of slope and survival from renal failure by multivariate analysis (hazard ratio 0.08, 95%CI 0.03–0.19, P < 0.001). Benefit from immunosuppression could only be shown in a subset of high-risk patients. Treatment-related PR had the same long-term implication as spontaneous ones. Relapses from PR were high (47%) but often reversible.
A partial remission is an important therapeutic target with implications for both progression rate and renal survival.</description><identifier>ISSN: 0085-2538</identifier><identifier>EISSN: 1523-1755</identifier><identifier>DOI: 10.1111/j.1523-1755.2004.00873.x</identifier><identifier>PMID: 15327418</identifier><identifier>CODEN: KDYIA5</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Arterial hypertension. Arterial hypotension ; Biological and medical sciences ; Blood and lymphatic vessels ; Cardiology. Vascular system ; Clinical manifestations. Epidemiology. Investigative techniques. Etiology ; Cohort Studies ; Female ; Follow-Up Studies ; Glomerulonephritis ; Glomerulonephritis, Membranous - drug therapy ; Glomerulonephritis, Membranous - mortality ; Glomerulonephritis, Membranous - physiopathology ; Humans ; hypertension ; immunosuppression ; Immunosuppressive Agents - therapeutic use ; Male ; Medical sciences ; membranous glomerulonephritis ; Middle Aged ; Nephrology. Urinary tract diseases ; Nephropathies. Renovascular diseases. Renal failure ; partial remission ; prognosis ; Proteinuria - drug therapy ; Proteinuria - mortality ; Proteinuria - physiopathology ; Recurrence ; Registries ; relapse ; Remission Induction ; Renal failure ; Survival Analysis ; treatment</subject><ispartof>Kidney international, 2004-09, Vol.66 (3), p.1199-1205</ispartof><rights>2004 International Society of Nephrology</rights><rights>2004 INIST-CNRS</rights><rights>Copyright Nature Publishing Group Sep 2004</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c497t-74f4341c042458c100e5d04bd882a15dcf0c18e43f94830e15e10ba59c90c1983</citedby><cites>FETCH-LOGICAL-c497t-74f4341c042458c100e5d04bd882a15dcf0c18e43f94830e15e10ba59c90c1983</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/210111397?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16071541$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15327418$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Troyanov, Stéphan</creatorcontrib><creatorcontrib>Wall, Catherine A.</creatorcontrib><creatorcontrib>Scholey, James W.</creatorcontrib><creatorcontrib>Miller, Judith A.</creatorcontrib><creatorcontrib>Cattran, Daniel C.</creatorcontrib><creatorcontrib>For The Toronto Glomerulonephritis Registry Group</creatorcontrib><creatorcontrib>Toronto Glomerulonephritis Registry Group</creatorcontrib><title>Idiopathic membranous nephropathy: Definition and relevance of a partial remission</title><title>Kidney international</title><addtitle>Kidney Int</addtitle><description>Idiopathic membranous nephropathy: Definition and relevance of a partial remission
Membranous nephropathy (MGN) remains the most common cause of adult onset nephrotic syndrome, and within the primary glomerulonephritis group is a leading cause of renal failure. A complete remission (CR) confers an excellent long-term prognosis, but the quantitative benefits of partial remissions (PR) have not been defined.
This study evaluated the rate of renal function decline (slope), relapse, and renal survival in nephrotic MGN patients with CR, PR, or no remission (NR). Multivariate analysis included clinical and laboratory data at presentation and over follow-up, blood pressure control and agents employed, and immunosuppressive therapy.
The study cohort consisted of 348 nephrotic MGN patients with a minimum of 12 months follow-up identified from the Toronto Glomerulonephritis Registry. Over a median follow-up of 60 months, 102 experienced a CR, 136 had a PR, and 110 had no remission. A PR was independently predictive of slope and survival from renal failure by multivariate analysis (hazard ratio 0.08, 95%CI 0.03–0.19, P < 0.001). Benefit from immunosuppression could only be shown in a subset of high-risk patients. Treatment-related PR had the same long-term implication as spontaneous ones. Relapses from PR were high (47%) but often reversible.
A partial remission is an important therapeutic target with implications for both progression rate and renal survival.</description><subject>Adult</subject><subject>Arterial hypertension. Arterial hypotension</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Cardiology. Vascular system</subject><subject>Clinical manifestations. Epidemiology. Investigative techniques. Etiology</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Glomerulonephritis</subject><subject>Glomerulonephritis, Membranous - drug therapy</subject><subject>Glomerulonephritis, Membranous - mortality</subject><subject>Glomerulonephritis, Membranous - physiopathology</subject><subject>Humans</subject><subject>hypertension</subject><subject>immunosuppression</subject><subject>Immunosuppressive Agents - therapeutic use</subject><subject>Male</subject><subject>Medical sciences</subject><subject>membranous glomerulonephritis</subject><subject>Middle Aged</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Nephropathies. Renovascular diseases. Renal failure</subject><subject>partial remission</subject><subject>prognosis</subject><subject>Proteinuria - drug therapy</subject><subject>Proteinuria - mortality</subject><subject>Proteinuria - physiopathology</subject><subject>Recurrence</subject><subject>Registries</subject><subject>relapse</subject><subject>Remission Induction</subject><subject>Renal failure</subject><subject>Survival Analysis</subject><subject>treatment</subject><issn>0085-2538</issn><issn>1523-1755</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFkU1r3DAQhkVpaTZJf0KLKDQ3OyNLWsu9pelXIBAI7Vlo5THRYsuuZIfk33c2uyTQS3URmvfRMHrEGBdQClrn21LoShai1rqsAFQJYGpZPrxiq-fgNVtRVReVluaIHee8BTo3Et6yI6FlVSthVuz2qg3j5Oa74PmAwya5OC6ZR5zu0lP98TP_il2IYQ5j5C62PGGP9y565GPHHZ9cmoPrqTyEnAk6ZW8612d8d9hP2O_v335d_iyub35cXV5cF1419VzUqlNSCQ-qUtp4AYC6BbVpjamc0K3vwAuDSnaNMhJQaBSwcbrxDQWNkSfsbN93SuOfBfNsaQCPfe8i0hvsem2EqY0m8OM_4HZcUqTZbCWAfMqmJsjsIZ_GnBN2dkphcOnRCrA76XZrd27tzq3dSbdP0u0DXf1w6L9sBmxfLh4sE_DpALjsXd-RZB_yC7eGWmgliHu_56Kbl4TPgFKNqiVQ_mWfI2m9D5hs9gHpJ9qQ0M-2HcP_p_0LtSaoxw</recordid><startdate>20040901</startdate><enddate>20040901</enddate><creator>Troyanov, Stéphan</creator><creator>Wall, Catherine A.</creator><creator>Scholey, James W.</creator><creator>Miller, Judith A.</creator><creator>Cattran, Daniel C.</creator><general>Elsevier Inc</general><general>Nature Publishing</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20040901</creationdate><title>Idiopathic membranous nephropathy: Definition and relevance of a partial remission</title><author>Troyanov, Stéphan ; Wall, Catherine A. ; Scholey, James W. ; Miller, Judith A. ; Cattran, Daniel C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c497t-74f4341c042458c100e5d04bd882a15dcf0c18e43f94830e15e10ba59c90c1983</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Adult</topic><topic>Arterial hypertension. Arterial hypotension</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Cardiology. Vascular system</topic><topic>Clinical manifestations. Epidemiology. Investigative techniques. Etiology</topic><topic>Cohort Studies</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Glomerulonephritis</topic><topic>Glomerulonephritis, Membranous - drug therapy</topic><topic>Glomerulonephritis, Membranous - mortality</topic><topic>Glomerulonephritis, Membranous - physiopathology</topic><topic>Humans</topic><topic>hypertension</topic><topic>immunosuppression</topic><topic>Immunosuppressive Agents - therapeutic use</topic><topic>Male</topic><topic>Medical sciences</topic><topic>membranous glomerulonephritis</topic><topic>Middle Aged</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Nephropathies. Renovascular diseases. Renal failure</topic><topic>partial remission</topic><topic>prognosis</topic><topic>Proteinuria - drug therapy</topic><topic>Proteinuria - mortality</topic><topic>Proteinuria - physiopathology</topic><topic>Recurrence</topic><topic>Registries</topic><topic>relapse</topic><topic>Remission Induction</topic><topic>Renal failure</topic><topic>Survival Analysis</topic><topic>treatment</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Troyanov, Stéphan</creatorcontrib><creatorcontrib>Wall, Catherine A.</creatorcontrib><creatorcontrib>Scholey, James W.</creatorcontrib><creatorcontrib>Miller, Judith A.</creatorcontrib><creatorcontrib>Cattran, Daniel C.</creatorcontrib><creatorcontrib>For The Toronto Glomerulonephritis Registry Group</creatorcontrib><creatorcontrib>Toronto Glomerulonephritis Registry Group</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Kidney international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Troyanov, Stéphan</au><au>Wall, Catherine A.</au><au>Scholey, James W.</au><au>Miller, Judith A.</au><au>Cattran, Daniel C.</au><aucorp>For The Toronto Glomerulonephritis Registry Group</aucorp><aucorp>Toronto Glomerulonephritis Registry Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Idiopathic membranous nephropathy: Definition and relevance of a partial remission</atitle><jtitle>Kidney international</jtitle><addtitle>Kidney Int</addtitle><date>2004-09-01</date><risdate>2004</risdate><volume>66</volume><issue>3</issue><spage>1199</spage><epage>1205</epage><pages>1199-1205</pages><issn>0085-2538</issn><eissn>1523-1755</eissn><coden>KDYIA5</coden><abstract>Idiopathic membranous nephropathy: Definition and relevance of a partial remission
Membranous nephropathy (MGN) remains the most common cause of adult onset nephrotic syndrome, and within the primary glomerulonephritis group is a leading cause of renal failure. A complete remission (CR) confers an excellent long-term prognosis, but the quantitative benefits of partial remissions (PR) have not been defined.
This study evaluated the rate of renal function decline (slope), relapse, and renal survival in nephrotic MGN patients with CR, PR, or no remission (NR). Multivariate analysis included clinical and laboratory data at presentation and over follow-up, blood pressure control and agents employed, and immunosuppressive therapy.
The study cohort consisted of 348 nephrotic MGN patients with a minimum of 12 months follow-up identified from the Toronto Glomerulonephritis Registry. Over a median follow-up of 60 months, 102 experienced a CR, 136 had a PR, and 110 had no remission. A PR was independently predictive of slope and survival from renal failure by multivariate analysis (hazard ratio 0.08, 95%CI 0.03–0.19, P < 0.001). Benefit from immunosuppression could only be shown in a subset of high-risk patients. Treatment-related PR had the same long-term implication as spontaneous ones. Relapses from PR were high (47%) but often reversible.
A partial remission is an important therapeutic target with implications for both progression rate and renal survival.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>15327418</pmid><doi>10.1111/j.1523-1755.2004.00873.x</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Arterial hypertension. Arterial hypotension Biological and medical sciences Blood and lymphatic vessels Cardiology. Vascular system Clinical manifestations. Epidemiology. Investigative techniques. Etiology Cohort Studies Female Follow-Up Studies Glomerulonephritis Glomerulonephritis, Membranous - drug therapy Glomerulonephritis, Membranous - mortality Glomerulonephritis, Membranous - physiopathology Humans hypertension immunosuppression Immunosuppressive Agents - therapeutic use Male Medical sciences membranous glomerulonephritis Middle Aged Nephrology. Urinary tract diseases Nephropathies. Renovascular diseases. Renal failure partial remission prognosis Proteinuria - drug therapy Proteinuria - mortality Proteinuria - physiopathology Recurrence Registries relapse Remission Induction Renal failure Survival Analysis treatment |
| title | Idiopathic membranous nephropathy: Definition and relevance of a partial remission |
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