Expression of phospholipase A2 receptor antigen in idiopathic membranous nephropathy and its association with clinical features and prognosis / 中国医师杂志

ABSTRACT

Objective:To explore the relationship of phospholipase A2 receptor (PLA2R) antigen expression in renal tissue with clinical characteristics, prognosis of idiopathic membranous nephropathy (IMN) patients.Methods:292 patients with nephropathy diagnosed by renal biopsy from January 2008 to January 2018 were selected, including 156 cases of IMN, 45 cases of secondary membranous nephropathy, and 91 cases of non membranous nephropathy. The PLA2R antigen in renal tissues of each patient was detected by immunofluorescence. Patients with IMN were further divided into PLA2R antigen positive group (116 cases) and PLA2R antigen negative group (negative group, 40 cases), and the clinical characteristics and prognostic indicators of the two groups were compared and analyzed.Results:The positive rates of PLA2R antigen in IMN, secondary membranous nephropathy and non membranous nephropathy were 74.4%(116/156), 11.1%(5/45) and 0, respectively. The positive rate of PLA2R antigen in IMN was the highest (χ 2=16.338, P=0.006). In IMN patients, the majority of IMN patients were stage I membranous nephropathy (90%, 36/40) and stage II membranous nephropathy (62.9%, 73/116) in the positive group (χ 2=8.230, P=0.029). The complete remission rate of the negative group (79.4%, 27/34) was significantly higher than that of the positive group (43.6%, 44/101), and the difference was statistically significant (χ 2=10.656, P=0.021). Conclusions:The expression of PLA2R antigen in renal tissue plays an important role in the diagnosis of IMN, and it′s correlated with the pathological stage of IMN. The negative PLA2R in kidney tissue of IMN may indicate a good clinical prognosis.