Experts publish consensus statement on new approach to identifying kidney disorder

Forty-eight international experts on membranous nephropathy have co-authored a consensus report that calls for a new method of classifying diagnoses of the syndrome. They say the change would result in greater accuracy in diagnoses, which would open the door to improved patient care and targeted treatment. To call attention to the report, Kidney International and Mayo Clinic Proceedings have published the report simultaneously.

Membranous nephropathy is a kidney disorder that involves immunologic attack on structures inside the kidney that help filter wastes and fluids, and it's a relatively common cause of nephrotic syndrome in adults. Nephrotic syndrome is a kidney disorder that causes the body to leak relatively large amounts of protein into the urine. It causes swelling, particularly in the feet and ankles, and increases the risk of other health problems.

With current diagnostic processes, in approximately 70% of cases involving membranous nephropathy, it's classified as the primary cause of disease. In the remaining cases, it's classified as secondary to another recognized disease or cause.

"Recent discoveries have rendered the primary-secondary classification of membranous nephropathy anachronistic," says Karl Nath, M.B., Ch.B, a co-author of the report and editor-in-chief of Mayo Clinic Proceedings. "In its place, the Mayo Clinic Consensus Report on Membranous Nephropathy proposes a new two-step classification that incorporates recent discoveries, is clinically based and pragmatic."

The consensus report is the result of a Mayo Clinic-sponsored meeting in Rochester, Minnesota, on Oct. 29, 2022. The article in Mayo Clinic Proceedings and Kidney International outlines a diagnostic classification process that incorporates recent discoveries and emerging research.

In a commentary that accompanies the consensus statement in Mayo Clinic Proceedings, Dr. Nath and co-authors Lori A. Erickson, M.D., and Vesna Garovic, M.D., Ph.D., write that the consensus report makes clear the need for a new approach to diagnostic classification. "This new classification assimilates new knowledge as it emerges and provides a foundation for further discoveries in membranous nephropathy," says Dr. Nath.