Patient age and the prognosis of idiopathic membranous nephropathy

Makoto Yamaguchi, Masahiko Ando, Ryohei Yamamoto, Shinichi Akiyama, Sawako Kato, Takayuki Katsuno, Tomoki Kosugi, Waichi Sato, Naotake Tsuboi, Yoshinari Yasuda, Masashi Mizuno, Yasuhiko Ito, Seiichi Matsuo, Shoichi Maruyama

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Results: During a median observation period of 37 months, 103 (60.2%) patients achieved complete proteinuria remission, which was not significantly associated with patient age (P = 0.831). However, 13 (7.6%) patients were hospitalized because of infection. Multivariate Cox proportional hazards models identified older age [adjusted hazard ratio (HR) = 3.11, 95% confidence interval (CI): 1.45-7.49, per 10 years; P = 0.003], prednisolone use (adjusted HR = 11.8, 95% CI: 1.59-242.5; P = 0.014), and cyclosporine used in combination with prednisolone (adjusted HR = 10.3, 95% CI: 1.59-204.4; P = 0.012) as significant predictors of infection. A <25% decrease in proteinuria at 1 month after immunosuppressive therapy initiation also predicted infection (adjusted HR = 6.72, 95% CI: 1.51-37.8; P = 0.012).

Conclusions: Younger and older IMN patients had similar renal outcomes. However, older patients were more likely to develop infection when using immunosuppressants. Patients with a poor response in the first month following the initiation of immunosuppressive therapy should be carefully monitored for infection and may require a faster prednisolone taper.

Background: Idiopathic membranous nephropathy (IMN) is increasingly seen in older patients. However, differences in disease presentation and outcomes between older and younger IMN patients remain controversial. We compared patient characteristics between younger and older IMN patients.

Methods: We recruited 171 Japanese patients with IMN, including 90 (52.6%) patients <65 years old, 40 (23.4%) patients 65-70 years, and 41 (24.0%) patients ≥71 years. Clinical characteristics and outcomes were compared between younger and older IMN patients.

元の言語English
記事番号e110376
ジャーナルPloS one
9
発行部数10
DOI
出版物ステータスPublished - 20-10-2014

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

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    Yamaguchi, M., Ando, M., Yamamoto, R., Akiyama, S., Kato, S., Katsuno, T., Kosugi, T., Sato, W., Tsuboi, N., Yasuda, Y., Mizuno, M., Ito, Y., Matsuo, S., & Maruyama, S. (2014). Patient age and the prognosis of idiopathic membranous nephropathy. PloS one, 9(10), [e110376]. https://doi.org/10.1371/journal.pone.0110376