Clinicopathological features and prognosis of idiopathic membranous nephropathy with thyroid dysfunction

Peiheng Wang; Shulei Wang; Bo Huang; Yiming Liu; Yingchun Liu; Huiming Chen; Junjun Zhang

doi:10.3389/fendo.2023.1133521

Clinicopathological features and prognosis of idiopathic membranous nephropathy with thyroid dysfunction

Front Endocrinol (Lausanne). 2023 Mar 16:14:1133521. doi: 10.3389/fendo.2023.1133521. eCollection 2023.

Authors

Peiheng Wang^{1

2}, Shulei Wang^{1

2}, Bo Huang^{1

2}, Yiming Liu^{1

2}, Yingchun Liu^{1

2}, Huiming Chen^{1

2}, Junjun Zhang^{1

2}

Affiliations

¹ Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
² Research Institute of Nephrology, Zhengzhou University, Zhengzhou, Henan, China.

Abstract

Background: Thyroid dysfunction is common in patients with kidney disease. However, the relationship between thyroid dysfunction and idiopathic membranous nephropathy (IMN) remains unclear. This retrospective study aimed to investigate the clinicopathological characteristics and prognosis of patients with IMN and thyroid dysfunction compared to patients with IMN and without thyroid dysfunction.

Methods: A total of 1052 patients with IMN diagnosed by renal biopsy were enrolled in this study, including 736 (70%) with normal thyroid function and 316 (30%) with abnormal thyroid function. We analyzed the clinicopathological features and prognostic data between the two groups, using propensity score matching (PSM) to reduce the bias. Logistic regression analysis was performed to investigate the risk factors for IMN combined with thyroid dysfunction. Kaplan-Meier curves and Cox regression analysis were used to evaluate the association between thyroid dysfunction and IMN.

Results: Patients with IMN and thyroid dysfunction exhibited more severe clinical features. Female sex, lower albumin level, higher D-dimer level, severe proteinuria, and decreased estimated glomerular filtration rate were predictors of thyroid dysfunction in patients with IMN. After PSM, 282 pairs were successfully matched. Results from the Kaplan-Meier curves indicated that the thyroid dysfunction group had a lower complete remission rate (P = 0.044), higher relapse rate (P < 0.001), and lower renal survival rate (P = 0.004). The multivariate Cox regression analysis revealed that thyroid dysfunction was an independent risk factor for complete remission [hazard ratio (HR) = 0.810, P = 0.045], relapse (HR = 1.721, P = 0.001), and composite endpoint event (HR = 2.113, P = 0.014) in IMN.

Conclusions: Thyroid dysfunction is relatively common in patients with IMN, and the clinical indicators are more severe in these patients. Thyroid dysfunction is an independent risk factor for poor prognosis in patients with IMN. More attention should be paid to thyroid function in patients with IMN.

Keywords: clinicopathological features; idiopathic membranous nephropathy; prognosis; propensity score matching; thyroid function.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Female
Glomerulonephritis, Membranous* / complications
Glomerulonephritis, Membranous* / diagnosis
Humans
Prognosis
Recurrence
Retrospective Studies
Thyroid Gland / pathology

Grants and funding

This study was supported by the National Nature Science Foundation of China (grant number 82170721).