ABSTRACT
Objective To evaluate the diagnostic significance of PLA2R and IgG4 in elderly patients with idiopathic membranous nephropathy (IMN).Methods The clinical data were retrospectively analyzed of patients with IMN (49 males and 49 females,aged 66.6 ± 5.4 years) or Non-IMN (57 males and 41 females,aged 67.1 ± 6.5 years) who were admitted in the authors served Department of Nephrology from Apr.2014 to Feb.2016 and accepted renal biopsy.SPSS13.0 was employed to evaluate the sensitivity,specificity and calculate the area under ROC curve (AUC) of serum anti-PLA2R antibody,glomerular PLA2R and IgG1-4 subclasses on diagnosing IMN.Results On diagnosing IMN,the sensitivity and specificity of serum anti-PLA2R antibody were 77.6％ and 89.8％ [AUC=0.869(0.816-0.923)],of glomerular PLA2R were 66.3％ and 94.9％ [AUC=0.805(0.741-0.87)],and of glomerular IgGl-IgG4 were 80.6％ and 78.6％,60.2％ and 83.7％,41.8％ and 84.7％,and 93.9％ and 89.8％,respectively [AUC=0.767(0.696-0.838),0.709(0.635-0.783),0.628(0.549-0.706) and 0.94(0.901-0.978),respectively].As to the combined use of glomerular PLA2R and IgG4 on diagnosing IMN,the sensitivity was 93.9％ when either one of glomerular PLA2R and IgG4 was positive,or the specificity was 96.9％ when both glomerular PLA2R and IgG4 were positive.Conclusion PLA2R and IgG4 can effectively serve the diagnosis of IMN,and the combined use of PLA2R and IgG4 may be better than single indicator alone.