{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T08:32:43Z","timestamp":1771662763762,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,1,18]],"date-time":"2018-01-18T00:00:00Z","timestamp":1516233600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The clinical course of idiopathic membranous nephropathy (IMN) varies from spontaneous remission of nephrotic syndrome (NS) to end\u2010stage renal disease (ESRD). The aim of the study was baseline identification of patients with high risk of progression for which immunosuppressive therapy is mandatory.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Eighty\u2010six IMN subjects were followed for a median of 69\u00a0months (range 6\u2013253). Receiver operating characteristic curve and Cox proportional hazards model were used to evaluate prognostic factors for progression, defined as ESRD or estimated glomerular filtration rate (eGFR) reduction \u226550% of baseline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among all, 24 subjects had progression. Area under the ROC curve of N\u2010acetyl\u2010\u03b2\u2010glucosaminidase\/creatinine ratio (NAG\/C) were significantly higher than proteinuria\/24\u00a0h (0.770 and 0.637 respectively, <jats:italic>P =<\/jats:italic> 0.018). In Cox proportional hazards regression analysis, NAG\/C and eGFR were independent predictors of progression. Compared to lowest tertile of NAG\/C (&lt;9.4 UI\/gC) or highest tertile of eGFR (\u226588\u00a0mL\/min per 1.73m<jats:sup>2<\/jats:sup>), the multivariable\u2010adjusted hazard ratio of highest tertile of NAG\/C (\u226519.2) was 18.97 (95%CI, 1.70\u2013211.86) and lowest tertile of eGFR (&lt;59) was 11.58 (95%CI, 2.02\u201366.29). Subjects with high NAG\/C or low eGFR (high\u2010risk, <jats:italic>n<\/jats:italic>\u00a0=\u00a043) had greater progression rate compared to moderate to low NAG\/C and high eGFR (low\u2010risk, <jats:italic>n<\/jats:italic>\u00a0=\u00a043) with or without NS at baseline (Log\u2010rank test <jats:italic>P =<\/jats:italic> 0.001 and 0.006, respectively). In NS subjects (<jats:italic>n<\/jats:italic>\u00a0=\u00a065), high\u2010risk group progression rate was significantly higher (91% vs. 29%, <jats:italic>P =<\/jats:italic> 0.003) and remission rate significantly lower (0% vs. 42%, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) in non\u2010immunosuppressed compared to steroids and cyclophosphamide treated patients; no significant differences were observed in low\u2010risk group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Idiopathic membranous nephropathy subjects with high NAG\/C and low eGFR have greater risk of progression, and immunosuppressive treatment is suggested at diagnosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nep.12952","type":"journal-article","created":{"date-parts":[[2016,10,20]],"date-time":"2016-10-20T21:36:40Z","timestamp":1476999400000},"page":"175-182","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Urinary N\u2010acetyl\u2010<b>\u03b2<\/b>\u2010glucosaminidase and estimated Glomerular filtration rate may identify patients to be treated with immuno\u2010suppression at diagnosis in idiopathic membranous nephropathy"],"prefix":"10.1111","volume":"23","author":[{"given":"Claudio","family":"Bazzi","sequence":"first","affiliation":[{"name":"D'Amico Foundation for Renal Disease Research San Carlo Borromeo Hospital Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoko","family":"Usui","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Endocrinology the University of Tokyo School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Virginia","family":"Rizza","sequence":"additional","affiliation":[{"name":"Biochemical Laboratory San Carlo Borromeo Hospital Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Casellato","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit San Carlo Borromeo Hospital Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2011-2160","authenticated-orcid":false,"given":"Maurizio","family":"Gallieni","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit San Carlo Borromeo Hospital Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaomi","family":"Nangaku","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Endocrinology the University of Tokyo School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,1,18]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)60731-0"},{"key":"e_1_2_7_3_1","doi-asserted-by":"crossref","first-page":"104936","DOI":"10.1371\/journal.pone.0104936","article-title":"The diagnosis accuracy of PLA2R\u2010AB in the Diagnosis of Idiopathic Membranous Nephropaty: A Meta\u2010Analysis","volume":"9","author":"Du Y","year":"2014","journal-title":"PLoS One"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.10471013"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2013040430"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.03850414"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2010111125"},{"key":"e_1_2_7_8_1","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1159\/000430849","article-title":"A Multicenter Randomized Controlled Trial of Rituximab versus Cyclosporine in the Treatment of Idiopathic Membranous Nephropathy (MENTOR)","volume":"130","author":"Fervenza FC","year":"2015","journal-title":"Nephron"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2014070640"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1159\/000368589"},{"key":"e_1_2_7_11_1","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1177\/1087057116629916","article-title":"Novel Biomarkers for Renal Diseases? None for the Moment (but One)","volume":"7","author":"Gentile G","year":"2016","journal-title":"J. Biomol. Screen."},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.12104"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfu261"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/1755-1536-3-7"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2005070757"},{"key":"e_1_2_7_16_1","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1093\/ndt\/gfs379","article-title":"Low\u2010 and high\u2010molecular weight proteins as predictors of response to rituximab in patients with membranous nephropathy: a prospective study","volume":"28","author":"Irazabal MW","year":"2013","journal-title":"Nephrol. Dial. Transplant."},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfk074"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365513.2010.542828"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.2002.00108.x"},{"key":"e_1_2_7_20_1","doi-asserted-by":"crossref","first-page":"929","DOI":"10.2215\/CJN.05711108","article-title":"In Crescentic IgA Nephropathy Fractional Excretion of IgG in combination with Nephron Loss is the Best Predictor of Progression and Responsiveness to Immunosuppression","volume":"4","author":"Bazzi C","year":"2009","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.5301\/jn.5000069"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/941831"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2369-15-74"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2004040287"},{"key":"e_1_2_7_25_1","doi-asserted-by":"crossref","first-page":"2846","DOI":"10.2215\/CJN.04020411","article-title":"Low\u2010Molecular\u2010Weight Proteins as Prognostic Markers in Idiopathic Membranous Nephropathy","volume":"6","author":"Jan AJG","year":"2011","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/17.11.1890"},{"key":"e_1_2_7_27_1","first-page":"14","article-title":"Urinary protein and enzyme excretion as markers of tubular damage","volume":"38","author":"D'Amico G","year":"2003","journal-title":"Curr. Opin. Nephrol. Hypertens."},{"key":"e_1_2_7_28_1","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1038\/kisup.2012.20","article-title":"KDIGO Clinical Practice Guideline for Glomerulonephritis. Chapter 7: Idiopathic membranous nephropathy","volume":"2","author":"Kidney Disease Improving Global Outcomes","year":"2012","journal-title":"Kidney Int. Suppl."},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-150-9-200905050-00006"},{"key":"e_1_2_7_30_1","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1681\/ASN.V93444","article-title":"A randomized study comparing methylprednisolone plus clorambucil versus methylprednisolone plus cyclophosphamide in idiopathic membranous nephropathy","volume":"9","author":"Ponticelli C","year":"1998","journal-title":"J. Am. Soc. Nephrol."},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.07570712"}],"container-title":["Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fnep.12952","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fnep.12952","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.12952","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T22:10:26Z","timestamp":1695852626000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nep.12952"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1,18]]},"references-count":30,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2018,2]]}},"alternative-id":["10.1111\/nep.12952"],"URL":"https:\/\/doi.org\/10.1111\/nep.12952","archive":["Portico"],"relation":{},"ISSN":["1320-5358","1440-1797"],"issn-type":[{"value":"1320-5358","type":"print"},{"value":"1440-1797","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,1,18]]},"assertion":[{"value":"2016-08-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-10-18","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-01-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}