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Клинико-морфологические особенности идиопатической мембранозной нефропатии с фокально-сегментарным гломерулосклерозом
Клинико-морфологические особенности идиопатической мембранозной нефропатии с фокально-сегментарным гломерулосклерозом
Камышова Е.С., Бобкова И.Н., Кахсуруева П.А., Абдулаева А.С., Руденко Т.Е., Ставровская Е.В., Андреева Е.Ю., Ли О.А., Суворов А.Ю. Клинико-морфологические особенности идиопатической мембранозной нефропатии с фокально-сегментарным гломерулосклерозом. Терапевтический архив. 2024;96(6):580–586. DOI: 10.26442/00403660.2024.06.202725
© ООО «КОНСИЛИУМ МЕДИКУМ», 2024 г.
© ООО «КОНСИЛИУМ МЕДИКУМ», 2024 г.
________________________________________________
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Аннотация
Цель. Изучить влияние вторичного фокального сегментарного гломерулосклероза (ФСГС) на клиническую картину и прогноз идиопатической мембранозной нефропатии (ИМН) в отечественной когорте пациентов.
Материалы и методы. В одноцентровое ретроспективное когортное исследование включили 101 пациента с морфологически подтвержденной ИМН. В группах, выделенных в зависимости от наличия вторичного ФСГС (ИМН и ИМН+ФСГС), сравнили клинико-лабораторные и морфологические показатели. В подгруппе из 59 пациентов оценили почечные исходы.
Результаты. На момент биопсии почки медиана возраста составила 46,0 (33,0; 55,0) года, длительность ИМН – 6,8 (4,0; 15,6) мес. Вторичный ФСГС выявлен у 15 (14,9%) пациентов с ИМН. Исследуемые группы не различались по соотношению полов, возрасту начала ИМН и проведения биопсии почки. У пациентов с ИМН и ФСГС по сравнению с пациентами без ФСГС была выше протеинурия при одинаковых уровнях альбумина и общего белка в крови, ниже расчетная скорость клубочковой фильтрации, а также наблюдалась тенденция к более высоким уровням артериального давления и креатинина. Частота анти-PLA2R-позитивности в группах ИМН и ИМН+ФСГС не различалась. Прогрессирование хронической болезни почек (ХБП) наблюдалось у 10/52 (19,2%) и 5/7 (71,4%) пациентов в группах ИМН и ИМН+ФСГС соответственно (р=0,009). По данным многофакторного регрессионного анализа Кокса, с прогрессированием ХБП были ассоциированы возраст проведения нефробиопсии (отношение шансов – ОШ 1,12, 95% доверительный интервал – ДИ 1,03–1,22; р=0,07), наличие ФСГС (ОШ 0,05, 95% ДИ 0,01–0,34; р=0,002) и ответ на 1-й курс иммуносупрессивной терапии (ОШ 0,33, 95% ДИ 0,12–0,95; р=0,039).
Заключение. Вторичный ФСГС у пациентов с ИМН обусловливает бόльшую выраженность протеинурии и снижения расчетной скорости клубочковой фильтрации, а также является независимым фактором прогрессирования ХБП.
Ключевые слова: идиопатическая мембранозная нефропатия, фокально-сегментарный гломерулосклероз, прогрессирование хронической болезни почек
Materials and methods. 101 patients with morphologically verified IMN were enrolled in our single-center cohort retrospective study. The patients were divided into IMN group and IMN+FSGS group. The primary and secondary outcomes were analyzed in 59 patients, which had follow-up data for period more than 6 months.
Results. At the time of renal biopsy the median age was 46.0 (33.0; 55.0) years and the median follow-up was 6.8 (4.0; 15.6) months. Secondary FSGS was revealed in 15 (14.9%) patients with IMN. The IMN and IMN+FSGS groups did not differ in gender, age of onset IMN and age of renal biopsy. In the IMN+FSGS group proteinuria was higher and estimated glomerular filtration rate was lower than that in the IMN group (p<0.05). The systolic arterial pressure and creatinine levels in the IMN+FSGS group were slightly higher than in the IMN group, but the difference was not significant. Anti-PLA2R positivity was similar in both groups. Chronic kidney disease (CKD) progression was observed in 10/52 (19.2%) and 5/7 (71.4%) patients in IMN and IMN+FSGS groups, respectively. In a multivariate Cox regression model, age of renal biopsy (odds ratio – OR 1.12, 95% confidence interval – CI 1.03–1.22; р=0.07), FSGS (OR 0.05, 95% CI 0.01–0.34; р=0.002) и response to initial course of immunosuppression (OR 0.33, 95% CI 0.12–0.95; р=0.039) were associated with the CKD progression.
Conclusion. In patients with IMN secondary FSGS is associated with a greater severity of proteinuria and a decrease in estimated glomerular filtration rate, and is also an independent factor of the CKD progression.
Keywords: idiopathic membranous nephropathy, focal segmental sclerosis, chronic kidney diseases progression
Материалы и методы. В одноцентровое ретроспективное когортное исследование включили 101 пациента с морфологически подтвержденной ИМН. В группах, выделенных в зависимости от наличия вторичного ФСГС (ИМН и ИМН+ФСГС), сравнили клинико-лабораторные и морфологические показатели. В подгруппе из 59 пациентов оценили почечные исходы.
Результаты. На момент биопсии почки медиана возраста составила 46,0 (33,0; 55,0) года, длительность ИМН – 6,8 (4,0; 15,6) мес. Вторичный ФСГС выявлен у 15 (14,9%) пациентов с ИМН. Исследуемые группы не различались по соотношению полов, возрасту начала ИМН и проведения биопсии почки. У пациентов с ИМН и ФСГС по сравнению с пациентами без ФСГС была выше протеинурия при одинаковых уровнях альбумина и общего белка в крови, ниже расчетная скорость клубочковой фильтрации, а также наблюдалась тенденция к более высоким уровням артериального давления и креатинина. Частота анти-PLA2R-позитивности в группах ИМН и ИМН+ФСГС не различалась. Прогрессирование хронической болезни почек (ХБП) наблюдалось у 10/52 (19,2%) и 5/7 (71,4%) пациентов в группах ИМН и ИМН+ФСГС соответственно (р=0,009). По данным многофакторного регрессионного анализа Кокса, с прогрессированием ХБП были ассоциированы возраст проведения нефробиопсии (отношение шансов – ОШ 1,12, 95% доверительный интервал – ДИ 1,03–1,22; р=0,07), наличие ФСГС (ОШ 0,05, 95% ДИ 0,01–0,34; р=0,002) и ответ на 1-й курс иммуносупрессивной терапии (ОШ 0,33, 95% ДИ 0,12–0,95; р=0,039).
Заключение. Вторичный ФСГС у пациентов с ИМН обусловливает бόльшую выраженность протеинурии и снижения расчетной скорости клубочковой фильтрации, а также является независимым фактором прогрессирования ХБП.
Ключевые слова: идиопатическая мембранозная нефропатия, фокально-сегментарный гломерулосклероз, прогрессирование хронической болезни почек
________________________________________________
Materials and methods. 101 patients with morphologically verified IMN were enrolled in our single-center cohort retrospective study. The patients were divided into IMN group and IMN+FSGS group. The primary and secondary outcomes were analyzed in 59 patients, which had follow-up data for period more than 6 months.
Results. At the time of renal biopsy the median age was 46.0 (33.0; 55.0) years and the median follow-up was 6.8 (4.0; 15.6) months. Secondary FSGS was revealed in 15 (14.9%) patients with IMN. The IMN and IMN+FSGS groups did not differ in gender, age of onset IMN and age of renal biopsy. In the IMN+FSGS group proteinuria was higher and estimated glomerular filtration rate was lower than that in the IMN group (p<0.05). The systolic arterial pressure and creatinine levels in the IMN+FSGS group were slightly higher than in the IMN group, but the difference was not significant. Anti-PLA2R positivity was similar in both groups. Chronic kidney disease (CKD) progression was observed in 10/52 (19.2%) and 5/7 (71.4%) patients in IMN and IMN+FSGS groups, respectively. In a multivariate Cox regression model, age of renal biopsy (odds ratio – OR 1.12, 95% confidence interval – CI 1.03–1.22; р=0.07), FSGS (OR 0.05, 95% CI 0.01–0.34; р=0.002) и response to initial course of immunosuppression (OR 0.33, 95% CI 0.12–0.95; р=0.039) were associated with the CKD progression.
Conclusion. In patients with IMN secondary FSGS is associated with a greater severity of proteinuria and a decrease in estimated glomerular filtration rate, and is also an independent factor of the CKD progression.
Keywords: idiopathic membranous nephropathy, focal segmental sclerosis, chronic kidney diseases progression
Полный текст
Список литературы
1. Alsharhan L, Beck LH Jr. Membranous nephropathy: Core curriculum 2021. Am J Kidney Dis. 2021;77(3):440-53. DOI:10.1053/j.ajkd.2020.10.009
2. Caravaca-Fontán F, Yandian F, Fervenza FC. Future landscape for the management of membranous nephropathy. Clin Kidney J. 2023;16(8):1228-38. DOI:10.1093/ckj/sfad041
3. Beck LH Jr, Bonegio RG, Lambeau G, et al. M-type phospholipase A2 receptor as target antigen in idiopathic membranous nephropathy. N Engl J Med. 2009;361(1):11-21. DOI:10.1056/NEJMoa0810457
4. Hofstra JM, Beck LH Jr, Beck DM, et al. Anti-phospholipase A2 receptor antibodies correlate with clinical status in idiopathic membranous nephropathy. Clin J Am Soc Nephrol. 2011;6(6):1286-91. DOI:10.2215/CJN.07210810
5. Добронравов В.А., Лапин С.В. Лазарева Н.М., и др. Циркулирующие антитела к рецептору фосфолипазы А2 при первичной мембранозной нефропатии. Нефрология. 2012;16(4):39-44 [Dobronravov VA, Lapin SV, Lazareva NM, et al. Circulating phospholipase A2 receptor antibodies in primary membranous nephropathy. Nephrology (Saint-Petersburg). 2012;16(4):39-44 (in Russian)].
6. De Vriese AS, Glassock RJ, Nath KA, et al. A proposal for a serology-based approach to membranous nephropathy. J Am Soc Nephrol. 2017;28(2):421-30. DOI:10.1681/ASN.2016070776
7. Beck LH Jr, Fervenza FC, Beck DM, et al. Rituximab-induced depletion of anti-PLA2R autoantibodies predicts response in membranous nephropathy. J Am Soc Nephrol. 2011;22(8):1543-50. DOI:10.1681/ASN.2010111125
8. Shiiki H, Saito T, Nishitani Y, et al. Prognosis and risk factors for idiopathic membranous nephropathy with nephrotic syndrome in Japan. Kidney Int. 2004;65(4):1400-7. DOI:10.1111/j.1523-1755.2004.00518.x
9. Horvatic I, Ljubanovic DG, Bulimbasic S, et al. Prognostic significance of glomerular and tubulointerstitial morphometry in idiopathic membranous nephropathy. Pathol Res Pract. 2012;208(11):662-7. DOI:10.1016/j.prp.2012.08.004
10. Zuo K, Wu Y, Li SJ, et al. Long-term outcome and prognostic factors of idiopathic membranous nephropathy in the Chinese population. Clin Nephrol. 2013;79(6):445-53. DOI:10.5414/CN107681
11. Huh H, Lee H, Lee JP, et al. Factors affecting the long-term outcomes of idiopathic membranous nephropathy. BMC Nephrol. 2017;18(1):104. DOI:10.1186/s12882-017-0525-6
12. Hoxha E, Harendza S, Pinnschmidt H, et al. M-type phospholipase A2 receptor autoantibodies and renal function in patients with primary membranous nephropathy. Clin J Am Soc Nephrol. 2014;9(11):1883-90. DOI:10.2215/CJN.03850414
13. Marx BE, Marx M. Prediction in idiopathic membranous nephropathy. Kidney Int. 1999;56(2):666-73. DOI:10.1046/j.1523-1755.1999.00598.x
14. He HG, Wu CQ, Ye K, et al. Focal segmental glomerulosclerosis, excluding atypical lesion, is a predictor of renal outcome in patients with membranous nephropathy: A retrospective analysis of 716 cases. BMC Nephrol. 2019;20(1):328. DOI:10.1186/s12882-019-1498-4
15. Van Damme B, Tardanico R, Vanrenterghem Y, Desmet V. Adhesions, focal sclerosis, protein crescents, and capsular lesions in membranous nephropathy. J Pathol.
1990;161(1):47-56. DOI:10.1002/path.1711610109
16. Wakai S, Magil AB. Focal glomerulosclerosis in idiopathic membranous glomerulonephritis. Kidney Int. 1992;41(2):428-34. DOI:10.1038/ki.1992.59
17. Lee HS, Koh HI. Nature of progressive glomerulosclerosis in human membranous nephropathy. Clin Nephrol. 1993;39(1):7-16. PMID: 8428410
18. Dumoulin A, Hill GS, Montseny JJ, Meyrier A. Clinical and morphological prognostic factors in membranous nephropathy: Significance of focal segmental glomerulosclerosis. Am J Kidney Dis. 2003;41(1):38-48. DOI:10.1053/ajkd.2003.50015
19. Troyanov S, Roasio L, Pandes M, et al. Renal pathology in idiopathic membranous nephropathy: A new perspective. Kidney Int. 2006;69(9):1641-8. DOI:10.1038/sj.ki.5000289
20. Heeringa SF, Branten AJ, Deegens JK, et al. Focal segmental glomerulosclerosis is not a sufficient predictor of renal outcome in patients with membranous nephropathy. Nephrol Dial Transplant. 2007;22(8):2201-7. DOI:10.1093/ndt/gfm188
21. Silva CAD, Custódio FB, Monteiro MLGDR, et al. Focal and segmental glomerulosclerosis and membranous nephropathy overlapping in a patient with nephrotic syndrome: A case report. J Bras Nefrol. 2020;42(1):113-7. DOI:10.1590/2175-8239-JBN-2018-0239
22. Gu QH, Cui Z, Huang J, et al. Patients with combined membranous nephropathy and focal segmental glomerulosclerosis have comparable clinical and autoantibody profiles with primary membranous nephropathy: A retrospective observational study. Medicine (Baltimore). 2016;95(21):e3786. DOI:10.1097/MD.0000000000003786
23. Gupta R, Sharma A, Mahanta PJ, et al. Focal segmental glomerulosclerosis in idiopathic membranous glomerulonephritis: A clinico-pathological and stereological study. Nephrol Dial Transplant. 2010;25(2):444-9. DOI:10.1093/ndt/gfp521
24. Li J, Chen B, Gao C, et al. Clinical and pathological features of idiopathic membranous nephropathy with focal segmental sclerosis. BMC Nephrol. 2019;20(1):467. DOI:10.1186/s12882-019-1641-2
25. Кахсуруева П.А., Камышова Е.С., Бобкова И.Н., и др. Клиническое значение антител к рецептору фосфолипазы А2 М-типа у пациентов с первичной мембранозной нефропатией. Клиническая фармакология и терапия. 2023;23(4):45-50 [Kakhsurueva P, Kamyshova E, Bobkova I, et al. Clinical significance of antibodies to the M type phospholipase A2 receptor in patients with primary membranous nephropathy. Klinicheskaya farmakologiya i terapiya = Clin Pharmacol Ther. 2023;32(4):45-50 (in Russian)].
DOI:10.32756/0869-5490-2023-4-45-50.
26. Rovin BH, Adler SG, Barratt J, et al. Executive summary of the KDIGO 2021 Guideline for the Management of Glomerular Diseases. Kidney Int. 2021;100(4):753-79. DOI:10.1016/j.kint.2021.05.015
27. Nijenhuis T, Sloan AJ, Hoenderop JG, et al. Angiotensin II contributes to podocyte injury by increasing TRPC6 expression via an NFAT-mediated positive feedback signaling pathway. Am J Pathol. 2011;179(4):1719-32. DOI:10.1016/j.ajpath.2011.06.033
28. Feutren G, Mihatsch MJ. Risk factors for cyclosporine-induced nephropathy in patients with autoimmune diseases. International Kidney Biopsy Registry of Cyclosporine in Autoimmune Diseases. N Engl J Med. 1992;326(25):1654-60. DOI:10.1056/NEJM199206183262502
29. He HG, Huang YY, Liang QQ, et al. Calcineurin inhibitors or cyclophosphamide in the treatment of membranous nephropathy superimposed with FSGS lesions: A retrospective study from China. Ren Fail. 2023;45(2):2253930. DOI:10.1080/0886022X.2023.2253930
2. Caravaca-Fontán F, Yandian F, Fervenza FC. Future landscape for the management of membranous nephropathy. Clin Kidney J. 2023;16(8):1228-38. DOI:10.1093/ckj/sfad041
3. Beck LH Jr, Bonegio RG, Lambeau G, et al. M-type phospholipase A2 receptor as target antigen in idiopathic membranous nephropathy. N Engl J Med. 2009;361(1):11-21. DOI:10.1056/NEJMoa0810457
4. Hofstra JM, Beck LH Jr, Beck DM, et al. Anti-phospholipase A2 receptor antibodies correlate with clinical status in idiopathic membranous nephropathy. Clin J Am Soc Nephrol. 2011;6(6):1286-91. DOI:10.2215/CJN.07210810
5. Dobronravov VA, Lapin SV, Lazareva NM, et al. Circulating phospholipase A2 receptor antibodies in primary membranous nephropathy. Nephrology (Saint-Petersburg).
2012;16(4):39-44 (in Russian).
6. De Vriese AS, Glassock RJ, Nath KA, et al. A proposal for a serology-based approach to membranous nephropathy. J Am Soc Nephrol. 2017;28(2):421-30. DOI:10.1681/ASN.2016070776
7. Beck LH Jr, Fervenza FC, Beck DM, et al. Rituximab-induced depletion of anti-PLA2R autoantibodies predicts response in membranous nephropathy. J Am Soc Nephrol. 2011;22(8):1543-50. DOI:10.1681/ASN.2010111125
8. Shiiki H, Saito T, Nishitani Y, et al. Prognosis and risk factors for idiopathic membranous nephropathy with nephrotic syndrome in Japan. Kidney Int. 2004;65(4):1400-7. DOI:10.1111/j.1523-1755.2004.00518.x
9. Horvatic I, Ljubanovic DG, Bulimbasic S, et al. Prognostic significance of glomerular and tubulointerstitial morphometry in idiopathic membranous nephropathy. Pathol Res Pract. 2012;208(11):662-7. DOI:10.1016/j.prp.2012.08.004
10. Zuo K, Wu Y, Li SJ, et al. Long-term outcome and prognostic factors of idiopathic membranous nephropathy in the Chinese population. Clin Nephrol. 2013;79(6):445-53. DOI:10.5414/CN107681
11. Huh H, Lee H, Lee JP, et al. Factors affecting the long-term outcomes of idiopathic membranous nephropathy. BMC Nephrol. 2017;18(1):104. DOI:10.1186/s12882-017-0525-6
12. Hoxha E, Harendza S, Pinnschmidt H, et al. M-type phospholipase A2 receptor autoantibodies and renal function in patients with primary membranous nephropathy. Clin J Am Soc Nephrol. 2014;9(11):1883-90. DOI:10.2215/CJN.03850414
13. Marx BE, Marx M. Prediction in idiopathic membranous nephropathy. Kidney Int. 1999;56(2):666-73. DOI:10.1046/j.1523-1755.1999.00598.x
14. He HG, Wu CQ, Ye K, et al. Focal segmental glomerulosclerosis, excluding atypical lesion, is a predictor of renal outcome in patients with membranous nephropathy: A retrospective analysis of 716 cases. BMC Nephrol. 2019;20(1):328. DOI:10.1186/s12882-019-1498-4
15. Van Damme B, Tardanico R, Vanrenterghem Y, Desmet V. Adhesions, focal sclerosis, protein crescents, and capsular lesions in membranous nephropathy. J Pathol.
1990;161(1):47-56. DOI:10.1002/path.1711610109
16. Wakai S, Magil AB. Focal glomerulosclerosis in idiopathic membranous glomerulonephritis. Kidney Int. 1992;41(2):428-34. DOI:10.1038/ki.1992.59
17. Lee HS, Koh HI. Nature of progressive glomerulosclerosis in human membranous nephropathy. Clin Nephrol. 1993;39(1):7-16. PMID: 8428410
18. Dumoulin A, Hill GS, Montseny JJ, Meyrier A. Clinical and morphological prognostic factors in membranous nephropathy: Significance of focal segmental glomerulosclerosis. Am J Kidney Dis. 2003;41(1):38-48. DOI:10.1053/ajkd.2003.50015
19. Troyanov S, Roasio L, Pandes M, et al. Renal pathology in idiopathic membranous nephropathy: A new perspective. Kidney Int. 2006;69(9):1641-8. DOI:10.1038/sj.ki.5000289
20. Heeringa SF, Branten AJ, Deegens JK, et al. Focal segmental glomerulosclerosis is not a sufficient predictor of renal outcome in patients with membranous nephropathy. Nephrol Dial Transplant. 2007;22(8):2201-7. DOI:10.1093/ndt/gfm188
21. Silva CAD, Custódio FB, Monteiro MLGDR, et al. Focal and segmental glomerulosclerosis and membranous nephropathy overlapping in a patient with nephrotic syndrome: A case report. J Bras Nefrol. 2020;42(1):113-7. DOI:10.1590/2175-8239-JBN-2018-0239
22. Gu QH, Cui Z, Huang J, et al. Patients with combined membranous nephropathy and focal segmental glomerulosclerosis have comparable clinical and autoantibody profiles with primary membranous nephropathy: A retrospective observational study. Medicine (Baltimore). 2016;95(21):e3786. DOI:10.1097/MD.0000000000003786
23. Gupta R, Sharma A, Mahanta PJ, et al. Focal segmental glomerulosclerosis in idiopathic membranous glomerulonephritis: A clinico-pathological and stereological study. Nephrol Dial Transplant. 2010;25(2):444-9. DOI:10.1093/ndt/gfp521
24. Li J, Chen B, Gao C, et al. Clinical and pathological features of idiopathic membranous nephropathy with focal segmental sclerosis. BMC Nephrol. 2019;20(1):467. DOI:10.1186/s12882-019-1641-2
25. Kakhsurueva P, Kamyshova E, Bobkova I, et al. Clinical significance of antibodies to the M type phospholipase A2 receptor in patients with primary membranous nephropathy. Klinicheskaya farmakologiya i terapiya = Clin Pharmacol Ther. 2023;32(4):45-50 (in Russian). DOI:10.32756/0869-5490-2023-4-45-50.
26. Rovin BH, Adler SG, Barratt J, et al. Executive summary of the KDIGO 2021 Guideline for the Management of Glomerular Diseases. Kidney Int. 2021;100(4):753-79. DOI:10.1016/j.kint.2021.05.015
27. Nijenhuis T, Sloan AJ, Hoenderop JG, et al. Angiotensin II contributes to podocyte injury by increasing TRPC6 expression via an NFAT-mediated positive feedback signaling pathway. Am J Pathol. 2011;179(4):1719-32. DOI:10.1016/j.ajpath.2011.06.033
28. Feutren G, Mihatsch MJ. Risk factors for cyclosporine-induced nephropathy in patients with autoimmune diseases. International Kidney Biopsy Registry of Cyclosporine in Autoimmune Diseases. N Engl J Med. 1992;326(25):1654-60. DOI:10.1056/NEJM199206183262502
29. He HG, Huang YY, Liang QQ, et al. Calcineurin inhibitors or cyclophosphamide in the treatment of membranous nephropathy superimposed with FSGS lesions: A retrospective study from China. Ren Fail. 2023;45(2):2253930. DOI:10.1080/0886022X.2023.2253930
2. Caravaca-Fontán F, Yandian F, Fervenza FC. Future landscape for the management of membranous nephropathy. Clin Kidney J. 2023;16(8):1228-38. DOI:10.1093/ckj/sfad041
3. Beck LH Jr, Bonegio RG, Lambeau G, et al. M-type phospholipase A2 receptor as target antigen in idiopathic membranous nephropathy. N Engl J Med. 2009;361(1):11-21. DOI:10.1056/NEJMoa0810457
4. Hofstra JM, Beck LH Jr, Beck DM, et al. Anti-phospholipase A2 receptor antibodies correlate with clinical status in idiopathic membranous nephropathy. Clin J Am Soc Nephrol. 2011;6(6):1286-91. DOI:10.2215/CJN.07210810
5. Добронравов В.А., Лапин С.В. Лазарева Н.М., и др. Циркулирующие антитела к рецептору фосфолипазы А2 при первичной мембранозной нефропатии. Нефрология. 2012;16(4):39-44 [Dobronravov VA, Lapin SV, Lazareva NM, et al. Circulating phospholipase A2 receptor antibodies in primary membranous nephropathy. Nephrology (Saint-Petersburg). 2012;16(4):39-44 (in Russian)].
6. De Vriese AS, Glassock RJ, Nath KA, et al. A proposal for a serology-based approach to membranous nephropathy. J Am Soc Nephrol. 2017;28(2):421-30. DOI:10.1681/ASN.2016070776
7. Beck LH Jr, Fervenza FC, Beck DM, et al. Rituximab-induced depletion of anti-PLA2R autoantibodies predicts response in membranous nephropathy. J Am Soc Nephrol. 2011;22(8):1543-50. DOI:10.1681/ASN.2010111125
8. Shiiki H, Saito T, Nishitani Y, et al. Prognosis and risk factors for idiopathic membranous nephropathy with nephrotic syndrome in Japan. Kidney Int. 2004;65(4):1400-7. DOI:10.1111/j.1523-1755.2004.00518.x
9. Horvatic I, Ljubanovic DG, Bulimbasic S, et al. Prognostic significance of glomerular and tubulointerstitial morphometry in idiopathic membranous nephropathy. Pathol Res Pract. 2012;208(11):662-7. DOI:10.1016/j.prp.2012.08.004
10. Zuo K, Wu Y, Li SJ, et al. Long-term outcome and prognostic factors of idiopathic membranous nephropathy in the Chinese population. Clin Nephrol. 2013;79(6):445-53. DOI:10.5414/CN107681
11. Huh H, Lee H, Lee JP, et al. Factors affecting the long-term outcomes of idiopathic membranous nephropathy. BMC Nephrol. 2017;18(1):104. DOI:10.1186/s12882-017-0525-6
12. Hoxha E, Harendza S, Pinnschmidt H, et al. M-type phospholipase A2 receptor autoantibodies and renal function in patients with primary membranous nephropathy. Clin J Am Soc Nephrol. 2014;9(11):1883-90. DOI:10.2215/CJN.03850414
13. Marx BE, Marx M. Prediction in idiopathic membranous nephropathy. Kidney Int. 1999;56(2):666-73. DOI:10.1046/j.1523-1755.1999.00598.x
14. He HG, Wu CQ, Ye K, et al. Focal segmental glomerulosclerosis, excluding atypical lesion, is a predictor of renal outcome in patients with membranous nephropathy: A retrospective analysis of 716 cases. BMC Nephrol. 2019;20(1):328. DOI:10.1186/s12882-019-1498-4
15. Van Damme B, Tardanico R, Vanrenterghem Y, Desmet V. Adhesions, focal sclerosis, protein crescents, and capsular lesions in membranous nephropathy. J Pathol.
1990;161(1):47-56. DOI:10.1002/path.1711610109
16. Wakai S, Magil AB. Focal glomerulosclerosis in idiopathic membranous glomerulonephritis. Kidney Int. 1992;41(2):428-34. DOI:10.1038/ki.1992.59
17. Lee HS, Koh HI. Nature of progressive glomerulosclerosis in human membranous nephropathy. Clin Nephrol. 1993;39(1):7-16. PMID: 8428410
18. Dumoulin A, Hill GS, Montseny JJ, Meyrier A. Clinical and morphological prognostic factors in membranous nephropathy: Significance of focal segmental glomerulosclerosis. Am J Kidney Dis. 2003;41(1):38-48. DOI:10.1053/ajkd.2003.50015
19. Troyanov S, Roasio L, Pandes M, et al. Renal pathology in idiopathic membranous nephropathy: A new perspective. Kidney Int. 2006;69(9):1641-8. DOI:10.1038/sj.ki.5000289
20. Heeringa SF, Branten AJ, Deegens JK, et al. Focal segmental glomerulosclerosis is not a sufficient predictor of renal outcome in patients with membranous nephropathy. Nephrol Dial Transplant. 2007;22(8):2201-7. DOI:10.1093/ndt/gfm188
21. Silva CAD, Custódio FB, Monteiro MLGDR, et al. Focal and segmental glomerulosclerosis and membranous nephropathy overlapping in a patient with nephrotic syndrome: A case report. J Bras Nefrol. 2020;42(1):113-7. DOI:10.1590/2175-8239-JBN-2018-0239
22. Gu QH, Cui Z, Huang J, et al. Patients with combined membranous nephropathy and focal segmental glomerulosclerosis have comparable clinical and autoantibody profiles with primary membranous nephropathy: A retrospective observational study. Medicine (Baltimore). 2016;95(21):e3786. DOI:10.1097/MD.0000000000003786
23. Gupta R, Sharma A, Mahanta PJ, et al. Focal segmental glomerulosclerosis in idiopathic membranous glomerulonephritis: A clinico-pathological and stereological study. Nephrol Dial Transplant. 2010;25(2):444-9. DOI:10.1093/ndt/gfp521
24. Li J, Chen B, Gao C, et al. Clinical and pathological features of idiopathic membranous nephropathy with focal segmental sclerosis. BMC Nephrol. 2019;20(1):467. DOI:10.1186/s12882-019-1641-2
25. Кахсуруева П.А., Камышова Е.С., Бобкова И.Н., и др. Клиническое значение антител к рецептору фосфолипазы А2 М-типа у пациентов с первичной мембранозной нефропатией. Клиническая фармакология и терапия. 2023;23(4):45-50 [Kakhsurueva P, Kamyshova E, Bobkova I, et al. Clinical significance of antibodies to the M type phospholipase A2 receptor in patients with primary membranous nephropathy. Klinicheskaya farmakologiya i terapiya = Clin Pharmacol Ther. 2023;32(4):45-50 (in Russian)].
DOI:10.32756/0869-5490-2023-4-45-50.
26. Rovin BH, Adler SG, Barratt J, et al. Executive summary of the KDIGO 2021 Guideline for the Management of Glomerular Diseases. Kidney Int. 2021;100(4):753-79. DOI:10.1016/j.kint.2021.05.015
27. Nijenhuis T, Sloan AJ, Hoenderop JG, et al. Angiotensin II contributes to podocyte injury by increasing TRPC6 expression via an NFAT-mediated positive feedback signaling pathway. Am J Pathol. 2011;179(4):1719-32. DOI:10.1016/j.ajpath.2011.06.033
28. Feutren G, Mihatsch MJ. Risk factors for cyclosporine-induced nephropathy in patients with autoimmune diseases. International Kidney Biopsy Registry of Cyclosporine in Autoimmune Diseases. N Engl J Med. 1992;326(25):1654-60. DOI:10.1056/NEJM199206183262502
29. He HG, Huang YY, Liang QQ, et al. Calcineurin inhibitors or cyclophosphamide in the treatment of membranous nephropathy superimposed with FSGS lesions: A retrospective study from China. Ren Fail. 2023;45(2):2253930. DOI:10.1080/0886022X.2023.2253930
________________________________________________
2. Caravaca-Fontán F, Yandian F, Fervenza FC. Future landscape for the management of membranous nephropathy. Clin Kidney J. 2023;16(8):1228-38. DOI:10.1093/ckj/sfad041
3. Beck LH Jr, Bonegio RG, Lambeau G, et al. M-type phospholipase A2 receptor as target antigen in idiopathic membranous nephropathy. N Engl J Med. 2009;361(1):11-21. DOI:10.1056/NEJMoa0810457
4. Hofstra JM, Beck LH Jr, Beck DM, et al. Anti-phospholipase A2 receptor antibodies correlate with clinical status in idiopathic membranous nephropathy. Clin J Am Soc Nephrol. 2011;6(6):1286-91. DOI:10.2215/CJN.07210810
5. Dobronravov VA, Lapin SV, Lazareva NM, et al. Circulating phospholipase A2 receptor antibodies in primary membranous nephropathy. Nephrology (Saint-Petersburg).
2012;16(4):39-44 (in Russian).
6. De Vriese AS, Glassock RJ, Nath KA, et al. A proposal for a serology-based approach to membranous nephropathy. J Am Soc Nephrol. 2017;28(2):421-30. DOI:10.1681/ASN.2016070776
7. Beck LH Jr, Fervenza FC, Beck DM, et al. Rituximab-induced depletion of anti-PLA2R autoantibodies predicts response in membranous nephropathy. J Am Soc Nephrol. 2011;22(8):1543-50. DOI:10.1681/ASN.2010111125
8. Shiiki H, Saito T, Nishitani Y, et al. Prognosis and risk factors for idiopathic membranous nephropathy with nephrotic syndrome in Japan. Kidney Int. 2004;65(4):1400-7. DOI:10.1111/j.1523-1755.2004.00518.x
9. Horvatic I, Ljubanovic DG, Bulimbasic S, et al. Prognostic significance of glomerular and tubulointerstitial morphometry in idiopathic membranous nephropathy. Pathol Res Pract. 2012;208(11):662-7. DOI:10.1016/j.prp.2012.08.004
10. Zuo K, Wu Y, Li SJ, et al. Long-term outcome and prognostic factors of idiopathic membranous nephropathy in the Chinese population. Clin Nephrol. 2013;79(6):445-53. DOI:10.5414/CN107681
11. Huh H, Lee H, Lee JP, et al. Factors affecting the long-term outcomes of idiopathic membranous nephropathy. BMC Nephrol. 2017;18(1):104. DOI:10.1186/s12882-017-0525-6
12. Hoxha E, Harendza S, Pinnschmidt H, et al. M-type phospholipase A2 receptor autoantibodies and renal function in patients with primary membranous nephropathy. Clin J Am Soc Nephrol. 2014;9(11):1883-90. DOI:10.2215/CJN.03850414
13. Marx BE, Marx M. Prediction in idiopathic membranous nephropathy. Kidney Int. 1999;56(2):666-73. DOI:10.1046/j.1523-1755.1999.00598.x
14. He HG, Wu CQ, Ye K, et al. Focal segmental glomerulosclerosis, excluding atypical lesion, is a predictor of renal outcome in patients with membranous nephropathy: A retrospective analysis of 716 cases. BMC Nephrol. 2019;20(1):328. DOI:10.1186/s12882-019-1498-4
15. Van Damme B, Tardanico R, Vanrenterghem Y, Desmet V. Adhesions, focal sclerosis, protein crescents, and capsular lesions in membranous nephropathy. J Pathol.
1990;161(1):47-56. DOI:10.1002/path.1711610109
16. Wakai S, Magil AB. Focal glomerulosclerosis in idiopathic membranous glomerulonephritis. Kidney Int. 1992;41(2):428-34. DOI:10.1038/ki.1992.59
17. Lee HS, Koh HI. Nature of progressive glomerulosclerosis in human membranous nephropathy. Clin Nephrol. 1993;39(1):7-16. PMID: 8428410
18. Dumoulin A, Hill GS, Montseny JJ, Meyrier A. Clinical and morphological prognostic factors in membranous nephropathy: Significance of focal segmental glomerulosclerosis. Am J Kidney Dis. 2003;41(1):38-48. DOI:10.1053/ajkd.2003.50015
19. Troyanov S, Roasio L, Pandes M, et al. Renal pathology in idiopathic membranous nephropathy: A new perspective. Kidney Int. 2006;69(9):1641-8. DOI:10.1038/sj.ki.5000289
20. Heeringa SF, Branten AJ, Deegens JK, et al. Focal segmental glomerulosclerosis is not a sufficient predictor of renal outcome in patients with membranous nephropathy. Nephrol Dial Transplant. 2007;22(8):2201-7. DOI:10.1093/ndt/gfm188
21. Silva CAD, Custódio FB, Monteiro MLGDR, et al. Focal and segmental glomerulosclerosis and membranous nephropathy overlapping in a patient with nephrotic syndrome: A case report. J Bras Nefrol. 2020;42(1):113-7. DOI:10.1590/2175-8239-JBN-2018-0239
22. Gu QH, Cui Z, Huang J, et al. Patients with combined membranous nephropathy and focal segmental glomerulosclerosis have comparable clinical and autoantibody profiles with primary membranous nephropathy: A retrospective observational study. Medicine (Baltimore). 2016;95(21):e3786. DOI:10.1097/MD.0000000000003786
23. Gupta R, Sharma A, Mahanta PJ, et al. Focal segmental glomerulosclerosis in idiopathic membranous glomerulonephritis: A clinico-pathological and stereological study. Nephrol Dial Transplant. 2010;25(2):444-9. DOI:10.1093/ndt/gfp521
24. Li J, Chen B, Gao C, et al. Clinical and pathological features of idiopathic membranous nephropathy with focal segmental sclerosis. BMC Nephrol. 2019;20(1):467. DOI:10.1186/s12882-019-1641-2
25. Kakhsurueva P, Kamyshova E, Bobkova I, et al. Clinical significance of antibodies to the M type phospholipase A2 receptor in patients with primary membranous nephropathy. Klinicheskaya farmakologiya i terapiya = Clin Pharmacol Ther. 2023;32(4):45-50 (in Russian). DOI:10.32756/0869-5490-2023-4-45-50.
26. Rovin BH, Adler SG, Barratt J, et al. Executive summary of the KDIGO 2021 Guideline for the Management of Glomerular Diseases. Kidney Int. 2021;100(4):753-79. DOI:10.1016/j.kint.2021.05.015
27. Nijenhuis T, Sloan AJ, Hoenderop JG, et al. Angiotensin II contributes to podocyte injury by increasing TRPC6 expression via an NFAT-mediated positive feedback signaling pathway. Am J Pathol. 2011;179(4):1719-32. DOI:10.1016/j.ajpath.2011.06.033
28. Feutren G, Mihatsch MJ. Risk factors for cyclosporine-induced nephropathy in patients with autoimmune diseases. International Kidney Biopsy Registry of Cyclosporine in Autoimmune Diseases. N Engl J Med. 1992;326(25):1654-60. DOI:10.1056/NEJM199206183262502
29. He HG, Huang YY, Liang QQ, et al. Calcineurin inhibitors or cyclophosphamide in the treatment of membranous nephropathy superimposed with FSGS lesions: A retrospective study from China. Ren Fail. 2023;45(2):2253930. DOI:10.1080/0886022X.2023.2253930
Авторы
Е.С. Камышова*1, И.Н. Бобкова1, П.А. Кахсуруева2, А.С. Абдулаева1, Т.Е. Руденко1, Е.В. Ставровская1, Е.Ю. Андреева1, О.А. Ли1, А.Ю. Суворов1
1ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Москва, Россия;
2ГБУЗ «Городская поликлиника №134» Департамента здравоохранения г. Москвы, Москва, Россия
*kamyshova_e_s@staff.sechenov.ru
1Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia;
2Municipal Polyclinic No. 134, Moscow, Russia
*kamyshova_e_s@staff.sechenov.ru
1ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Москва, Россия;
2ГБУЗ «Городская поликлиника №134» Департамента здравоохранения г. Москвы, Москва, Россия
*kamyshova_e_s@staff.sechenov.ru
________________________________________________
1Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia;
2Municipal Polyclinic No. 134, Moscow, Russia
*kamyshova_e_s@staff.sechenov.ru
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