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- Title
The association of serum anti-PLA2R antibody and glomerular PLA2R antigen staining with clinical manifestations and outcomes in membranous nephropathy.
- Authors
Yang, Shi-Feng; Xie, Xin-Fang; Lu, Wan-Hong; Lan, Ping; Liu, Hui; Jin, Li
- Abstract
Background: Phospholipase A2 receptor (PLA2R)-associated membranous nephropathy (MN) was manifested as seropositive for PLA2R antibodies (SAb) and/or glomerular PLA2R antigens' (GAg) deposits. According to the test of SAb and GAg, PLA2R-associated MN can be divided into SAb + /GAg−, SAb−/GAg + , and SAb + /GAg + groups. The clinical characteristics and outcomes of the three groups need to be further evaluated. Methods: 184 PLA2R-associated MN patients were enrolled. SAb was measured by enzyme-linked immunosorbent assay with a cut-off value of 14 RU/mL. GAg was detected by immunofluorescence using a paraffin section of renal biopsy samples. Clinical characteristics and the decline of eGFR were compared among the 3 groups. Results: There were 33 SAb + /GAg−, 46 SAb−/GAg +, and 105 SAb + /GAg + PLA2R-associated MN patients reviewed. Clinical characteristics, such as the level of proteinuria, serum albumin, as well as eGFR, were comparable between the SAb + /GAg− and SAb + /GAg + patients. While SAb−/GAg + patients exhibited mild clinical manifestations as evidenced by higher serum albumin (P < 0.001) and lower proteinuria (p = 0.049) compared with SAb + /GAg + patients. After 21.96 ± 7.39 month follow-up, the eGFR decrease was no difference between the SAb + /GAg− and SAb + /GAg + patients. SAb−/GAg + patients had a lower rate of the > 20% eGFR decline as well as a 50% eGFR decline compared with the SAb + /GAg + patients (10.87% vs 30.48%, p = 0.013; 0.00% vs 4.76%, p = 0.324). Conclusions: Our study showed that the clinical manifestations of SAb + /Gag− patients were the same as those of double-positive patients, while SAb−/GAg + patients exhibited mild clinical manifestations and slower eGFR decline compared to the double-positive patients.
- Subjects
SYMPTOMS; ENZYME-linked immunosorbent assay; PHOSPHOLIPASE A2; KIDNEY diseases; SERUM albumin; ANTIGENS
- Publication
Clinical & Experimental Nephrology, 2023, Vol 27, Issue 12, p1060
- ISSN
1342-1751
- Publication type
Article
- DOI
10.1007/s10157-023-02399-x