Assessment of the feasibility of using positive anti-M-type phospholipase A 2receptor antibody detection as a noninvasive diagnostic tool for idiopathic membranous nephropathy in elderly Chinese patients
10.3760/cma.j.issn.0254-9026.2023.10.009
- VernacularTitle:评估抗M型磷脂酶A 2受体抗体阳性无创诊断我国老年特发性膜性肾病的可行性
- Author:
Shan LU
1
;
Yijun DONG
;
Yan ZHANG
;
Jing XIAO
;
Zhanzheng ZHAO
Author Information
1. 郑州大学第一附属医院肾脏内科，郑州 450052
- Keywords:
Glomerulonephritis, membranous;
Phospholipase A 2;
Antibody
- From:
Chinese Journal of Geriatrics
2023;42(10):1196-1200
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the feasibility of using positive anti-M-type phospholipase A 2 receptor(PLA 2R)antibody detection as a surrogate for renal biopsy in the diagnosis of idiopathic membranous nephropathy(IMN)in elderly Chinese. Methods:From June 2021 to March 2022, clinicopathological data of ninety-six elderly patients(≥60 years old)with positive anti-PLA 2R antibody detection(ELISA≥14 RU/ml), complete renal pathology records, and the exclusion of secondary disease and diabetes mellitus were collected from the Department of Nephrology, The First Affiliated Hospital of Zhengzhou University.Patients were divided into high eGFR group(≥60 ml·min -1·1.73 m -2)and low eGFR group(<60 ml·min -1·1.73 m -2), and the data were analyzed retrospectively. Results:Of the 96 patients, 95(99.0%)had IMN(1 in stage Ⅰ, 59 in stage Ⅱ, 34 in stage Ⅲ, and 1 in stage Ⅳ), and 1(1.0%)had atypical membranous nephropathy(AMN).For the IMN patients, 81(85.3%)had high eGFR and most IMN patients(66.7%)were in stage Ⅱ, with 10(12.3%)showing additional pathological findings, including mild mesangial proliferative IgA nephropathy(2 cases)and subacute tubulointerstitial nephropathy(2 cases).There were 14 patients(14.7%)with low eGFR, and most of them(57.1%)had stage Ⅲ IMN, with 10(71.4%)showing additional pathological findings.This percentage was higher than that in the high eGFR group( χ2=21.642, P<0.05).The most common additional pathological findings were acute tubular injury(4 cases)and ischemic kidney injury(2 cases). Conclusions:Positive anti-PLA 2R antibody detection is highly predictive of IMN in elderly Chinese patients, but it often co-exists with other pathological entities.The advantages of renal biopsy in detecting other pathological conditions and the risks associated with the procedure should be evaluated.
