Our study confirmed the correlation between age and a combined outcome consisting of renal function progression, ESRD and death

Our study confirmed the correlation between age and a combined outcome consisting of renal function progression, ESRD and death. to test the performance of risk score. Results Totally 439 patients were recruited in this study. The median follow-up time was 38.73??19.35?months. The enrolled patients were 56 (15C83) years old with a male predominance (sex ratio: male vs female, 1:0.91). CALNB1 The median baseline serum albumin, eGFR-EPI and proteinuria were 23(8C43) g/l, 100.31(12.81C155.98) ml/min/1.73?m2 and 3.98(1.50C22.98) g/24?h, respectively. In total, there were 36 primary outcomes occurred. By Cox regression analysis, the best risk model included age [HR: 1.04(1.003C1.08), 95% CI from bootstrapping: 1.01C1.08), eGFR [HR: 0.97 (0.96C0.99), 95% CI from bootstrapping: 0.96C0.99) and proteinuria [HR: 1.09 (1.01C1.18), 95% CI from bootstrapping: 1.02C1.16). One unit increasing of the risk score based on the best model was associated with 2.57 (1.97C3.36) fold increased risk of combined outcome. The discrimination of this risk score was excellent in predicting combined outcome [C statistics: 0.83, 95% CI 0.76C0.90]. Conclusions Our study indicated that older IMN patients with lower eGFR and heavier proteinuria at the time of renal biopsy were at a higher risk for adverse outcomes. A risk score based on these three variables provides clinicians with an effective tool for risk stratification. Electronic supplementary material The online version of this article (10.1186/s12967-019-1792-8) contains supplementary material, which is available to authorized users. Keywords: Chronic kidney disease, Membranous nephropathy, Risk score, Prognosis Aldosterone D8 Background Idiopathic membranous nephropathy (IMN) is one of the most common types of adult-onset primary glomerulonephritis [1C3]. The incidence of IMN has increased dramatically recently at least in China [2, 4, 5] which maybe partly due to air pollution for example the increased level of PM2.5 in the air [5]. IMN is an immune complex-mediated glomerular disease. The understanding of the pathophysiological mechanism underlying IMN has been greatly improved thanks to the discovery of anti-PLA2R and anti-THSD7A antibodies in IMN patients [6, 7]. Interestingly, previous studies [8C10] based on western population have shown that the level of anti-PLA2R antibody in serum was helpful in the differential diagnosis and the prognosis prediction. It was reported that approximately one-third of all IMN patients will develop end stage renal disease (ESRD). Both Aldosterone D8 clinical variables including age, gender, serum creatinine, proteinuria and histological variables including tubulointerstitial fibrosis and focal segmental sclerosis(FSGS) at time of diagnosis were associated with renal function progression in IMN patients based on prior studies [11, 12]. However, Trayanov et al. [13] failed to validate the correlation between FSGS and progressive renal disease. Zent et al. [14] found that elderly and young patients had similar rates of ESRD (12% vs 18%, P?>?0.05) based on a Aldosterone D8 cohort of 323 IMN patients. The discrepant findings suggested validating studies were necessary in impartial cohorts with diverse populations since most of these studies were performed in Western countries. Finally, establishing a risk model to combine the impartial predictors could potentially improve the accuracy of prediction since the effect of each single predictor is relatively small. In this study, we enrolled an extended Chinese IMN cohort to establish a risk score to precisely predict the outcome of these patients. This prediction tool will Aldosterone D8 be helpful to clinicians for assessing the risk classification of IMN patients and to decide who need more aggressive treatments and more frequent follow-up. Methods Study population and study design All the patients in Aldosterone D8 this study were recruited at Shanghai Ruijin Hospital from 2009.01 to 2013.12. The inclusion criteria were as follows: (1) renal biopsy was required for the diagnosis of IMN; (2) age??15?years; (3) informed consent was obtained. The exclusion criteria were: (1) patients with secondary causes of membranous nephropathy, such as malignancy, autoimmune disease and hepatitis B. (2) Patients receiving immunosuppressive treatment before hospitalization in our nephrology support. (3) Patients with severe heart.