Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Sep;37(3):248-256.
doi: 10.23876/j.krcp.2018.37.3.248. Epub 2018 Sep 30.

Anti-phospholipase A2 receptor antibody as a prognostic marker in patients with primary membranous nephropathy

Eun Joo Song  1 , Kye Hwa Jeong  2 , Young Ae Yang  2 , Jeong-Hoon Lim  2 , Hee-Yeon Jung  2 , Ji-Young Choi  2 , Jang-Hee Cho  2 , Chan-Duck Kim  2 , Yong-Lim Kim  2 , Sun-Hee Park  2
Affiliations

Anti-phospholipase A2 receptor antibody as a prognostic marker in patients with primary membranous nephropathy

Eun Joo Song et al. Kidney Res Clin Pract. 2018 Sep.

Erratum in

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.

Keywords: Membranous nephropathy; Phospholipase A2 receptors; Prognosis.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest All authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1. Prevalence of anti-PLA2R ab in patients with membranous nephropathy (MN)
Anti-PLA2R ab, anti-phospholipase A2 receptor antibody; SLE, systemic lupus erythematosus; UPCR, urine protein/creatinine ratio.
Figure 2
Figure 2. Correlation analysis between anti-PLA2R ab level and proteinuria and serum albumin level of patients with primary membranous nephropathy (A and B) and of anti-PLA2R-positive patients (C and D)
Anti-PLA2R ab, anti-phospholipase A2 receptor antibody; UPCR, urine protein/creatinine ratio.
Figure 3
Figure 3. Kaplan–Meier analysis of anti-PLA2R ab level and cumulative probability of chronic kidney disease (CKD) stage 3 or more (A), complete remission (B), and spontaneous remission (C)
Anti-PLA2R ab, anti-phospholipase A2 receptor antibody.
See this image and copyright information in PMC

References

    1. Ponticelli C. Membranous nephropathy. J Nephrol. 2007;20:268–287. - PubMed
    1. Glassock RJ. The pathogenesis of idiopathic membranous nephropathy: a 50-year odyssey. Am J Kidney Dis. 2010;56:157–167. doi: 10.1053/j.ajkd.2010.01.008. - DOI - PubMed
    1. Makker SP, Tramontano A. Idiopathic membranous nephropathy: an autoimmune disease. Semin Nephrol. 2011;31:333–340. doi: 10.1016/j.semnephrol.2011.06.004. - DOI - PMC - PubMed
    1. Glassock RJ. Diagnosis and natural course of membranous nephropathy. Semin Nephrol. 2003;23:324–332. doi: 10.1016/S0270-9295(03)00049-4. - DOI - PubMed
    1. Ronco P, Debiec H. Pathophysiological advances in membranous nephropathy: time for a shift in patient’s care. Lancet. 2015;385:1983–1992. doi: 10.1016/S0140-6736(15)60731-0. - DOI - PubMed

LinkOut - more resources