Association of Systemic Immune Inflammation Index and Pan-immune Inflammation Value with Prognosis in Idiopathic Membranous Nephropathy

Fangqian  Liang; Yuyang  Yang; Yao  Sun; Lei  Xing; Xiaolong  Yu; Junzhi  Xia; Jingyuan  Gao

doi:10.18502/ijaai.v25i2.20797

Fangqian Liang Department of General Practice, North China University of Science and Technology Affiliated Hospital, Tangshan, China
Yuyang Yang College of Traditional Chinese Medicine, North China University of Science Technology, Tangshan, China
Yao Sun Department of General Practice, North China University of Science and Technology Affiliated Hospital, Tangshan, China
Lei Xing Department of General Practice, North China University of Science and Technology Affiliated Hospital, Tangshan, China
Xiaolong Yu Department of General Practice, North China University of Science and Technology Affiliated Hospital, Tangshan, China
Junzhi Xia Department of General Practice, North China University of Science and Technology Affiliated Hospital, Tangshan, China
Jingyuan Gao Department of General Practice, North China University of Science and Technology Affiliated Hospital, Tangshan, China

DOI: https://doi.org/10.18502/ijaai.v25i2.20797

Keywords: Idiopathic membranous nephropathy; Pan-immune inflammation value; Prognosis; Systemic immune inflammation index

Abstract

Idiopathic membranous nephropathy (IMN) presents a heterogeneous clinical course, with approximately 30% to 40% of patients experiencing spontaneous remission, while others respond poorly to treatment. This study aims to identify reliable biomarkers for risk stratification in IMN patients.

We conducted a prospective observational study involving 187 patients with IMN from February 2022 to February 2024. Patients were categorized into remission and non-remission groups based on clinical outcomes one year post-treatment. Comparative analyses revealed that the non-remission group exhibited significantly higher incidences of hypertension, elevated 24-hour urinary protein, higher serum creatinine levels, and increased inflammatory markers, including the systemic immune inflammation index (SII), systemic inflammation response index (SIRI), and pan-immune inflammation value (PIV). Conversely, the estimated glomerular filtration rate (eGFR) and lymphocyte-to-monocyte ratio (LMR) were lower in non-remission patients.

Spearman correlation identified hypertension, 24-hour urinary protein, and inflammatory indexes as positive correlates with non-remission, while eGFR showed a negative correlation.

Multivariate logistic regression confirmed hypertension, high 24-hour urinary protein, SII, SIRI, and PIV as independent risk factors for non-remission; eGFR was a protective factor. Receiver operating characteristic analysis revealed that SII and PIV effectively predicted non-remission (AUC=0.743 and 0.759, respectively). These findings underscore the potential of these indicators in assessing disease severity and guiding personalized treatment strategies.