association of systemic immune inflammation index and pan-immune inflammation value with prognosis in idiopathic membranous nephropathy

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.