{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T16:31:00Z","timestamp":1790353860223,"version":"4.1.0"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011,12]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Accurate prediction of prognosis in idiopathic membranous nephropathy (iMN) allows restriction of immunosuppressive therapy to patients at high risk for ESRD. Here we re-evaluate urinary low-molecular-weight proteins as prognostic markers and explore causes of misclassification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, setting, participants, &amp; measurements<\/jats:title>\n                    <jats:p>In a cohort of 129 patients with serum creatinine concentration &lt;135 \u03bcmol\/L and proteinuria \u22653.0 g\/10 mmol, urinary \u03b11- (u\u03b11m) and \u03b22-microglobulin (u\u03b22m) excretion rate was determined. Urinary \u03b11m and u\u03b22m-creatinine ratio was also obtained. We defined progression as a rise in serum creatinine \u226550% or \u226525% and an absolute level \u2265135 \u03bcmol\/L.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Median survival time was 25 months, and 47% of patients showed progression. The area under the receiver operating characteristic curve for u\u03b22m was 0.81 (95% CI: 0.73 to 0.89). Using a threshold value of 1.0 \u03bcg\/min, sensitivity and specificity were 73% and 75%, respectively. Similar accuracy was observed for the u\u03b22m-creatinine ratio with sensitivity and specificity of 75% and 73%, respectively, at a threshold of 1.0 \u03bcg\/10 mmol creatinine. Similar accuracy was found for u\u03b11m and u\u03b11m-creatinine ratio. Blood Pressure and cholesterol contributed to misclassification. Repeated measurements improved accuracy in patients with persistent proteinuria: the positive predictive value of u\u03b22m increased from 72% to 89% and the negative predictive value from 76% to 100%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Urinary excretion of u\u03b12m and u\u03b22m predict prognosis in iMN. A spot urine sample can be used instead of a timed sample. A repeated measurement after 6 to 12 months increases prognostic accuracy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2215\/cjn.04020411","type":"journal-article","created":{"date-parts":[[2011,12,9]],"date-time":"2011-12-09T15:07:16Z","timestamp":1323443236000},"page":"2846-2853","source":"Crossref","is-referenced-by-count":71,"title":["Low-Molecular-Weight Proteins as Prognostic Markers in Idiopathic Membranous Nephropathy"],"prefix":"10.2215","volume":"6","author":[{"given":"Jan A.J.G.","family":"van den Brand","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia M.","family":"Hofstra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack 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