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Pages: 1193-1197
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Profile of Membranous Nephropathy in Moroccan Patients: Experience of Nephrology Department in Rabat- Morocco

Author: mariam jdidou, T.Bouattar, L.Benamar, R.Bayahiya, N. Ouzeddoun

Category: JMSR Nephrology


Introduction: Membranous nephropathy is the most common cause of primary nephrotic syndromes in adults. Our study aims to describe the epidemiological, clinical, pathological and therapeutic aspects of patients with this condition in Morocco. Patients and Methods: We conducted a retrospective study in the nephrology department at Ibn Sina University Hospital in Rabat- Morocco, from January 2006 to December 2016. We included all cases of diagnosed MN, with a kidney biopsy and followed for at least 04 years. Results: Over 10 years, we identified 71 cases of MN; the mean age in our patients was 43.5 years old [20- 76] with a female predominance and a sex ratio of 0.8. Proteinuria was the main revealing sign; it was nephrotic in 87% of cases. Kidney failure was noted in 38%. Phospholipase A2 receptor antibodies were carried out in 43 cases and were positive in 24 patients (55.8%). Histologically, 47 patients had stage II MN, associated with interstitial fibrosis exceeding 50% in 10 patients. MN was idiopathic in 58 cases and secondary in 13. The etiologies retained were infectious (5 cases), autoimmune (5 cases) and neoplastic in 3 cases. Concerning idiopathic MN, all 58 patients received treatment with renin-angiotensin –aldosterone system blockers for 6 months. Twenty three of them received immunosuppressive therapy and only one patient received anti-CD20 therapy. Eighteen patients had complete remission after a mean follow-up of 8.4 months and 25 had partial remission. Five patients were in chronic renal failure and chronic end-stage renal failure was reported in 10 cases. Twelve patients relapsed after a mean delay of 20 months; seven of them were treated according to the classic Ponticelli protocol. Kidney failure at admission and interstitial fibrosis exceeding 50% were factors of poor renal prognosis. Conclusion: According to our study, primary MN is the most frequent in Moroccan patients; kidney failure at admission and interstitial fibrosis >50% seems to be associated to poor renal prognosis.

Keywords: kidney failure, membranous nephropathy, phospholipase A2 receptor antibodies (PLA2R) antibodies