Comparative analysis of membranous and other nephropathy subtypes and establishment of a diagnostic model

Front Med. 2019 Oct;13(5):618-625. doi: 10.1007/s11684-018-0620-5. Epub 2018 Aug 10.

Abstract

This study aimed to compare clinical features between membranous nephropathy (MN) and nonmembranous nephropathy (non-MN), to explore the clinically differential diagnosis of these two types, and to establish a diagnostic model of MN. After renal biopsy was obtained, 798 patients were divided into two groups based on their examination results: primary MN group (n = 248) and non-MN group (n = 550). Their data were statistically analyzed. Logistic regression analysis indicated that anti-PLA2R antibodies, IgG, and Cr were independently correlated with MN, and these three parameters were then used to establish the MN diagnostic model. A receiver operating characteristic (ROC) curve confirmed that our diagnostic model could distinguish between patients with and without MN, and their corresponding sensitivity, specificity, and AUC were 79.9%, 89.4%, and 0.917, respectively. The cutoff value for this combination in MN diagnosis was 0.34. The established diagnostic model that combined multiple factors shows a potential for broad clinical applications in differentiating primary MN from other kidney diseases and provides reliable evidence supporting the feasibility of noninvasive diagnosis of kidney diseases.

Keywords: diagnosis; membranous nephropathy; model; multiparameter analysis.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Autoantibodies / blood*
  • Autoantibodies / immunology
  • Female
  • Glomerulonephritis / classification
  • Glomerulonephritis / diagnosis*
  • Glomerulonephritis, Membranous / blood
  • Glomerulonephritis, Membranous / diagnosis*
  • Humans
  • Kidney / immunology
  • Kidney / pathology
  • Logistic Models
  • Male
  • Middle Aged
  • ROC Curve
  • Receptors, Phospholipase A2 / immunology*
  • Retrospective Studies
  • Sensitivity and Specificity

Substances

  • Autoantibodies
  • Receptors, Phospholipase A2