Clinical profile and outcome of primary membranous nephropathy: A tertiary care center experience from North India

Table 1 Risk stratification of patients with membranous nephropathy

Very high risk	High risk	Moderate risk	Low risk
Presence of any 2 of the following is considered to be at very high risk of disease progression: Serum creatinine > 1.5 mg/dL, considered to be due to MN; progressive decline in kidney function, > 25% decline in eGFR from the baseline over the prior 2 years; severe, disabling, or life-threatening nephrotic syndrome is defined by serum albumin < 2.5 g/dL and a refractory edema, or a thromboembolic event	Presence of ≥ 2 of the following is considered to be high risk: Decrease in eGFR > 25% not explained by other causes at any time during the observation period; proteinuria > 8 g/day at the end of the observation period or persistent nephrotic syndrome; patient is anti-PLA2R antibody positive, serial anti-PLA2R antibody titres are high (> 150 RU/mL by ELISA) and not decreasing or are increasing to > 150 RU/mL	Presence of ≥ 2 of the following: Normal or stable eGFR (< 25% decrease) over a 3-month to 6-month period; persistent proteinuria between 4 g/day and 8 g/day at the end of the observation period; patient is anti-PLA2R antibody positive, serial anti-PLA2R antibody titres are < 150 RU/mL by ELISA and stable or increasing by < 25% over 6-month period	Normal or stable eGFR (< 25% decrease) over a 3-month to 6-month period; proteinuria < 4 g/day at the end of the observation period; patient is anti-PLA2R antibody positive, serial anti-PLA2R antibody titres are persistently low < 50 RU/mL by ELISA or are decreasing by ≥ 25% at 3-month to 6-month period

eGFR: Estimated glomerular filtration rate; PLA2R: Phospholipase A2 receptor; ELISA: Enzyme-linked immunosorbent assay.