Clinical features, course and prognosis of idiopathic membranous nephropathy depending on the presence of antibodies against M-type phospholipase A2 receptor

Elías Jatem Escalante, Alfons Segarra Medrano, Clara Carnicer Cáceres, M. Adoración Martín-Gómez, María Teresa Salcedo Allende, Helena Ostos Roldan, Irene Agraz Pamplona

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    7 Citations (Scopus)

    Abstract

    © 2015 Sociedad Española de Nefrología. In membranous nephropathy, the presence of antibodies against M-type phospholipase A2 receptor is considered highly specific for idiopathic forms. However, no specific association to a particular clinical profile has been found for such antibodies. Objective: To assess potential differences in initial clinical profile, course and prognosis of idiopathic membranous nephropathy depending on the presence of anti-PLA2R antibodies. Methods: Eighty-five patients with idiopathic membranous nephropathy were included (55 anti-PLA2R-positive and 30 anti-PLA2R-negative). Clinical, biochemical and pathological variables were recorded at the time of diagnosis. Frequency of spontaneous remission, incidence of response to first-line therapy, frequency and number of recurrences, survival of renal function free from renal replacement therapy, survival of renal function free from chronic renal insufficiency and frequency of occurrence of malignant, infectious or autoimmune diseases during follow-up were recorded. Results: At the time of diagnosis, anti-PLA2R-negative patients were significantly older and had a higher frequency of spontaneous remission. No differences were noted in the response to first-line treatment, frequency and number of recurrences, survival of renal function free from renal replacement therapy, or survival of renal function free from chronic renal insufficiency. Conclusions: Anti-PLA2R-negative patients with idiopathic membranous nephropathy were older and experienced spontaneous remission more often than anti-PLA2R-positive patients. No differences in terms of treatment response, recurrences, and final prognosis were observed between both groups of patients.
    Original languageEnglish
    Pages (from-to)479-486
    JournalNefrologia
    Volume35
    Issue number5
    DOIs
    Publication statusPublished - 1 Sep 2015

    Keywords

    • Anti-PLA2R antibodies
    • Idiopathic membranous nephropathy
    • Nephrotic syndrome
    • Prognosis

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