Anti-phospholipase A2 receptor antibody as a prognostic marker in patients with primary membranous nephropathy.
10.23876/j.krcp.2018.37.3.248
- Author:
Eun Joo SONG
1
;
Kye Hwa JEONG
;
Young Ae YANG
;
Jeong Hoon LIM
;
Hee Yeon JUNG
;
Ji Young CHOI
;
Jang Hee CHO
;
Chan Duck KIM
;
Yong Lim KIM
;
Sun Hee PARK
Author Information
1. Department of Internal Medicine, Daehyun Chumdan Geriatric Hospital, Daegu, Korea.
- Publication Type:Original Article
- Keywords:
Membranous nephropathy;
Phospholipase A2 receptors;
Prognosis
- MeSH:
Antibodies;
Diagnosis;
Enzyme-Linked Immunosorbent Assay;
Follow-Up Studies;
Glomerulonephritis, Membranous*;
Humans;
Incidence;
Multivariate Analysis;
Prognosis;
Proteinuria;
Receptors, Phospholipase A2;
Remission, Spontaneous;
Renal Insufficiency, Chronic;
Risk Factors
- From:Kidney Research and Clinical Practice
2018;37(3):248-256
- CountryRepublic of Korea
- Language:English
-
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.
