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The aim of this study was to evaluate the efficacy of rituximab therapy in the management of idiopathic membranous nephropathy (IMN). After literature search, data from eligible studies were used to perform random-effects meta-analyses to estimate remission rates and changes in proteinuria at the latest follow-up after rituximab therapy. The outcomes were used for metaregression to identify the factors affecting the efficacy of rituximab. Twenty-one studies were included in the analysis (602 patients; age 50 years [95% CI 46.8, 53.3]; 30% females [95% CI 23, 31]). Follow-up duration was 20.3 months [95% CI 17.1, 23.5]. Remission rate (67% [95% CI 61, 73]) was higher in studies with below average baseline proteinuria (76% [95% CI 61, 88]) than in studies with above average baseline proteinuria (61% [95% CI 54, 68]). The complete and partial remission rates were 26% [95% CI 20, 33] and 37% [95% CI 31, 43], respectively. Rituximab therapy significantly reduced proteinuria (mean difference between final and baseline values: − 4.90 g/day [95% CI − 6.18, − 3.63]; p

The aim of this study was to investigate the number of autophagosomes in podocyte from kidney tissue of immunoglobulin A nephropathy (IgAN) and idiopathic membranous nephropathy (IMN).The changes in kidney tissue pathology were detected after hematoxylin and eosin, periodic acid-Schiff, Masson's trichrome and immunofluorescence. The autophagosomes of podocyte were analyzed by transmission electron microscopy. Clinical data, including age, gender, edema, serum creatinine, estimated glomerular filtrating rate (eGFR), hematuria, urine protein excretion and serum albumin, were collected from inpatient medical record.It was found that the number of autophagosomes in podocyte of nephropathy group was lower when compared to the control group. At the same time, we did not find the difference of the parameter between these two kinds of nephropathy. Further study showed that the index was affected by two factors: eGFR and gender. The cases with worse eGFR (eGFR 60 ml/min) and male patients presented more autophagosomes. Furthermore, each nephropathy had its own character. The phenomena of reduced autophagosomes were found in IMN cases, did not change from male to female, and further aggravated from pathological stage I to II. By contrast, IgAN cases with less eGFR exhibited more autophagosomes.Therefore, the results of the present study indicate that autophagy participates in podocyte injury and the progression of IgAN and IMN.

The article ‘Glomerulosclerosis predicts poor renal outcome in patients with idiopathic membranous nephropathy’, written by Cuimei Wei, Yongcheng He, Tong Li, Haofei Hu, Haiying Song, Dongli Qi, Yuan Cheng, Jia Chen, Mijie Guan, Xiaohua Xiao, Junyi Li, was originally published electronically on the publisher’s internet portal (currently SpringerLink) on 22 September 2020 with open access.