Anti-PLA2R Antibodies as a Prognostic Factor in PLA2R-Related Membranous Nephropathy

American Journal of Nephrology
Sjoerd A M E G TimmermansLimburg Renal Registry

Abstract

The natural course of idiopathic membranous nephropathy (MN) varies, as it is known through favorable outcomes in most patients. However, one third of patients with idiopathic MN will slowly progress to end-stage renal disease (ESRD). To prevent disease progression, patients at high risk to develop ESRD are treated with immunosuppressive agents. Therefore, a correct selection of patients who need immunosuppressive treatment is important. Here, we evaluated the prognostic value of anti-phospholipase A2 receptor 1 antibody (anti-PLA2R) levels regarding clinical outcome in a well-defined cohort of 73 PLA2R-related MN patients with long-term follow-up. At baseline, patients were subdivided into patients with either low or high antibody levels based on ELISA testing. Spontaneous remission rates were highest among patients with low anti-PLA2R levels (79%; hazard ratio 2.72 (95% CI 1.22-6.08), p = 0.02) after a median follow-up of 2.9 (95% CI 0.8-5.0, p < 0.001) years, whereas high anti-PLA2R levels were associated with persistent proteinuria (p = 0.04) and/or the need for immunosuppressive therapy (p < 0.001). Renal survival rates were 97% at 5 years, 93% at 10 years, and 89% at 15 years; however, this was not different between the a...Continue Reading

Citations

Jun 7, 2016·Kidney International·Min HuStephen I Alexander
Nov 1, 2016·Journal of the American Society of Nephrology : JASN·An S De VrieseFernando C Fervenza
Feb 9, 2017·Journal of Immunological Methods·Peter D BurbeloMeryl Waldman
Jul 4, 2017·Nature Reviews. Nephrology·Piero RuggenentiGiuseppe Remuzzi
Nov 16, 2018·Expert Review of Clinical Immunology·Rolf Ak StahlElion Hoxha
Sep 27, 2018·Kidney Research and Clinical Practice·Eun Joo SongSun-Hee Park
Nov 26, 2020·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Jiao LuoGuobao Wang
Apr 4, 2021·Journal of Clinical Medicine·Barbara MoszczukKrzysztof Mucha
Mar 14, 2019·Romanian Journal of Internal Medicine = Revue Roumaine De Médecine Interne·Simella ProvatopoulouAikaterini Papagianni
Apr 9, 2021·Frontiers in Immunology·Vladimir Tesar, Zdenka Hruskova
Jul 3, 2021·Journal of Clinical Medicine·Roxana JurubițăGener Ismail

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