Clinical Prediction Model for Disease Progression in Primary Membranous Nephropathy

Primary membranous nephropathy (pMN) is a leading cause of nephrotic syndrome in adults. Its clinical course is highly variable, ranging from spontaneous remission to progressive kidney function decline and end-stage kidney disease. Current prognostic assessment relies mainly on conventional clinical and laboratory parameters such as proteinuria, serum creatinine, estimated glomerular filtration rate (eGFR), and serum albumin. These markers have limited accuracy in predicting individual patient outcomes.

Several prognostic nomograms have been developed by combining clinical, laboratory, and immunological variables. However, most of these models were derived from single-center cohorts and require external validation in different populations.

This prospective observational study will evaluate clinical and laboratory predictors of disease progression in patients with biopsy-proven primary membranous nephropathy and assess the performance of a prognostic nomogram for predicting renal outcomes in patients attending Assiut University Hospitals.

Inclusion criteria

• Age ≥ 18 years
• Biopsy-proven primary membranous nephropathy
• Written informed consent

Exclusion criteria

• Secondary membranous nephropathy (e.g., lupus nephritis, hepatitis B or C, malignancy, drug-induced)
• Pregnancy
• End-stage kidney disease at presentation
• Refusal to participate