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    Mayo Clinic Proceedings, Kidney International 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, Mayo Clinic Proceedings and Kidney International 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, and was made possible by discoveries at Mayo Clinic. The article in Mayo Clinic Proceedings and Kidney International, the journal of the International Society of Nephrology, outlines a diagnostic classification process that incorporates recent discoveries and emerging research. Fernando Fervenza, M.D., Ph.D., director of Mayo Clinic's Nephrology Collaborative Group, is senior author. First author is Sanjeev Sethi, M.D., Ph.D., a Mayo Clinic pathologist who specializes in kidney diseases.

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.

Dr. Nath and Dr. Garovic are nephrologists in the Mayo Clinic Division of Nephrology and Hypertension, Department of Medicine, and Dr. Erickson is in the Department of Laboratory Medicine and Pathology.

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About Mayo Clinic Proceedings
Mayo Clinic Proceedings is a monthly peer-reviewed journal that publishes original articles and reviews on clinical and laboratory medicine, clinical research, basic science research and clinical epidemiology. The journal, sponsored by Mayo Foundation for Medical Education and Research as part of its commitment to physician education, has been published for 97 years and has a circulation of 127,000.

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