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The clinical outcome and risk factors of phospholipase A2 receptor-associated idiopathic membranous nephropathy in adults / 中华肾脏病杂志
Chinese Journal of Nephrology ; (12): 1-8, 2019.
Article in Chinese | WPRIM | ID: wpr-734918
ABSTRACT
Objective To report the spontaneous remission and induced remission of phospholipase A2 receptor (PLA2R)-associated idiopathic membranous nephropathy (IMN) in adults,as well as to explore the potential prognostic factors.Methods A total of 120 patients with IMN in Huashan Hospital during 2012 and 2017 were enrolled and their clinical data were collected.Results PLA2R-associated IMN patients accounted for 89.2% of the IMN patients.Spontaneous remission occurred in 35.5% of PLA2R-associated IMN patients.The patients with higher serum albumin and lower level of PLA2R antibody were more likely to achieve spontaneous remission (both P < 0.05).Multivariate logistic regression analysis showed that male was an independent risk factor for spontaneous remission in PLA2R-associated IMN patients (OR=0.060,95%CI 0.007-0.493,P=0.009),while higher serum albumin at baseline (OR=1.480,95% CI 1.144-1.932,P=0.004) and the improvement of serum albumin after 3 months' non-immunosuppressive treatment (OR=2.040,95%CI 1.322-3.151,P=0.001) were independent protective factors for spontaneous remission.About 42.1% PLA2R-associated IMN patients had received immunosuppressive therapy,with induced remission rate being 70.7%.High serum albumin before treatment was an independent protective factor for induced remission (OR=1.268,95% CI 1.014-1.585,P=0.038).Conclusions PLA2R-associated IMN accounts for most of the IMN patients,with a spontaneous remission rate of 35.5%,during the follow-up period,which is even higher in patients with higher baseline serum albumin and lower PLA2R antibody titer.Induced remission rate is 70.7% in patients in need of immunosuppresants.The serum albumin level may be helpful in predicting spontaneous remission and response to immunosuppressive therapy.

Full text: Available Index: WPRIM (Western Pacific) Type of study: Etiology study / Prognostic study / Risk factors Language: Chinese Journal: Chinese Journal of Nephrology Year: 2019 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Type of study: Etiology study / Prognostic study / Risk factors Language: Chinese Journal: Chinese Journal of Nephrology Year: 2019 Type: Article