Cargando…

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

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 w...

Descripción completa

Detalles Bibliográficos
Autores principales: Song, Eun Joo, Jeong, Kye Hwa, Yang, Young Ae, Lim, Jeong-Hoon, Jung, Hee-Yeon, Choi, Ji-Young, Cho, Jang-Hee, Kim, Chan-Duck, Kim, Yong-Lim, Park, Sun-Hee
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Nephrology 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6147192/
https://www.ncbi.nlm.nih.gov/pubmed/30254849
http://dx.doi.org/10.23876/j.krcp.2018.37.3.248
_version_ 1783356526067449856
author Song, Eun Joo
Jeong, Kye Hwa
Yang, Young Ae
Lim, Jeong-Hoon
Jung, Hee-Yeon
Choi, Ji-Young
Cho, Jang-Hee
Kim, Chan-Duck
Kim, Yong-Lim
Park, Sun-Hee
author_facet Song, Eun Joo
Jeong, Kye Hwa
Yang, Young Ae
Lim, Jeong-Hoon
Jung, Hee-Yeon
Choi, Ji-Young
Cho, Jang-Hee
Kim, Chan-Duck
Kim, Yong-Lim
Park, Sun-Hee
author_sort Song, Eun Joo
collection PubMed
description 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.
format Online
Article
Text
id pubmed-6147192
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Korean Society of Nephrology
record_format MEDLINE/PubMed
spelling pubmed-61471922018-09-25 Anti-phospholipase A2 receptor antibody as a prognostic marker in patients with primary membranous nephropathy Song, Eun Joo Jeong, Kye Hwa Yang, Young Ae Lim, Jeong-Hoon Jung, Hee-Yeon Choi, Ji-Young Cho, Jang-Hee Kim, Chan-Duck Kim, Yong-Lim Park, Sun-Hee Kidney Res Clin Pract Original Article 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. Korean Society of Nephrology 2018-09 2018-09-30 /pmc/articles/PMC6147192/ /pubmed/30254849 http://dx.doi.org/10.23876/j.krcp.2018.37.3.248 Text en Copyright © 2018 by The Korean Society of Nephrology This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Song, Eun Joo
Jeong, Kye Hwa
Yang, Young Ae
Lim, Jeong-Hoon
Jung, Hee-Yeon
Choi, Ji-Young
Cho, Jang-Hee
Kim, Chan-Duck
Kim, Yong-Lim
Park, Sun-Hee
Anti-phospholipase A2 receptor antibody as a prognostic marker in patients with primary membranous nephropathy
title Anti-phospholipase A2 receptor antibody as a prognostic marker in patients with primary membranous nephropathy
title_full Anti-phospholipase A2 receptor antibody as a prognostic marker in patients with primary membranous nephropathy
title_fullStr Anti-phospholipase A2 receptor antibody as a prognostic marker in patients with primary membranous nephropathy
title_full_unstemmed Anti-phospholipase A2 receptor antibody as a prognostic marker in patients with primary membranous nephropathy
title_short Anti-phospholipase A2 receptor antibody as a prognostic marker in patients with primary membranous nephropathy
title_sort anti-phospholipase a2 receptor antibody as a prognostic marker in patients with primary membranous nephropathy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6147192/
https://www.ncbi.nlm.nih.gov/pubmed/30254849
http://dx.doi.org/10.23876/j.krcp.2018.37.3.248
work_keys_str_mv AT songeunjoo antiphospholipasea2receptorantibodyasaprognosticmarkerinpatientswithprimarymembranousnephropathy
AT jeongkyehwa antiphospholipasea2receptorantibodyasaprognosticmarkerinpatientswithprimarymembranousnephropathy
AT yangyoungae antiphospholipasea2receptorantibodyasaprognosticmarkerinpatientswithprimarymembranousnephropathy
AT limjeonghoon antiphospholipasea2receptorantibodyasaprognosticmarkerinpatientswithprimarymembranousnephropathy
AT jungheeyeon antiphospholipasea2receptorantibodyasaprognosticmarkerinpatientswithprimarymembranousnephropathy
AT choijiyoung antiphospholipasea2receptorantibodyasaprognosticmarkerinpatientswithprimarymembranousnephropathy
AT chojanghee antiphospholipasea2receptorantibodyasaprognosticmarkerinpatientswithprimarymembranousnephropathy
AT kimchanduck antiphospholipasea2receptorantibodyasaprognosticmarkerinpatientswithprimarymembranousnephropathy
AT kimyonglim antiphospholipasea2receptorantibodyasaprognosticmarkerinpatientswithprimarymembranousnephropathy
AT parksunhee antiphospholipasea2receptorantibodyasaprognosticmarkerinpatientswithprimarymembranousnephropathy