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Anti-phospholipase A2 receptor antibody as a prognostic marker in patients with primary membranous nephropathy
Kidney Research and Clinical Practice ; : 248-256, 2018.
Article in English | WPRIM | ID: wpr-717214
ABSTRACT

BACKGROUND:

Phospholipase A2 receptor (PLA2R) has been identified as a major autoantigen in primary membranous nephropathy (MN). We evaluated the association between anti-PLA2R antibodies and clinical outcome in Korean patients with primary MN.

METHODS:

A total of 66 patients with biopsy-proven MN were included. Serum level of anti-PLA2R antibodies was measured by enzyme-linked immunosorbent assay. Biochemical parameters were estimated initially and at follow-up.

RESULTS:

Anti-PLA2R antibodies were detected in 52.1% and 27.8% of patients with primary and secondary MN, respectively. Forty-eight patients with primary MN were grouped based on presence or absence of anti-PLA2R antibodies. Proteinuria was more severe in anti-PLA2R-positive patients than in anti-PLA2R-negative patients (urine protein/creatinine ratio 7.922 ± 3.985 g/g vs. 4.318 ± 3.304 g/g, P = 0.001), and anti-PLA2R antibody level was positively correlated with proteinuria. The incidence of chronic kidney disease stage ≥ 3 was higher in anti-PLA2R-positive patients compared with anti-PLA2R-negative patients (P = 0.004). The probabilities of spontaneous remission were higher in anti-PLA2R-negative patients compared with anti-PLA2R-positive patients (P < 0.001). Multivariate analysis demonstrated that anti-PLA2R antibodies are an independent risk factor for developing chronic kidney disease stage ≥ 3 and for not reaching spontaneous remission.

CONCLUSION:

Detection of anti-PLA2R antibodies at diagnosis in patients with primary MN can predict prognosis and guide treatment decisions.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Prognosis / Proteinuria / Remission, Spontaneous / Enzyme-Linked Immunosorbent Assay / Glomerulonephritis, Membranous / Incidence / Multivariate Analysis / Risk Factors / Follow-Up Studies / Diagnosis Type of study: Diagnostic study / Etiology study / Incidence study / Observational study / Prognostic study / Risk factors Limits: Humans Language: English Journal: Kidney Research and Clinical Practice Year: 2018 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Prognosis / Proteinuria / Remission, Spontaneous / Enzyme-Linked Immunosorbent Assay / Glomerulonephritis, Membranous / Incidence / Multivariate Analysis / Risk Factors / Follow-Up Studies / Diagnosis Type of study: Diagnostic study / Etiology study / Incidence study / Observational study / Prognostic study / Risk factors Limits: Humans Language: English Journal: Kidney Research and Clinical Practice Year: 2018 Type: Article