Association of The Autoantibodies to M-Type Phospholipase A2 Receptor Titer with Clinical Characteristics and Outcome of Patients with Primary Membranous Nephropathy – 5-Year Follow up Study
oleh: Mario Laganović, Ivica Horvatić, Ivan Bubić, Mario Ilić, Bojana Maksimović, Ana Kozmar, Ivana Vuković Brinar, Matija Crnogorac, Marijana Živko, Margareta Fištrek, Željka Jureković, Danica Galešić Ljubanović, Marijana Ćorić, Stela Bulimbašić, Krešimir Galešić, Mladen Knotek
| Format: | Article |
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| Diterbitkan: | Sestre Milosrdnice University hospital, Institute of Clinical Medical Research 2021-01-01 |
Deskripsi
Introduction: primary membranous nephropathy (pMN) is glomerulopathy caused in the majority of cases by autoantibodies to Phospholipase-A2 receptors (PLA2R-AB). This study aimed to evaluate the clinical course and outcomes of the patients with pMN regarding PLA2R-AB status. Patients and methods: 32 patients (21 males, 11 females) with renal biopsy-proven pMN were included in the study. PLA2R-AB (ELI SA method) and outcomes (defined according to KDIGO) were evaluated after 21 and 64 months of follow-up in 28 patients. Results: 19 patients had positive PLA2R-AB (>20 RU /ml) (59.3%), with median titer of 97 (21-1418 RU /ml). The rate of remission in low PLA2R-AB titer group (< 200 RU /ml) after 21 months was significantly higher than in high PLA2R-AB group (> 200 RU /ml) (90% vs. 50%, p=0.045), and after 64 months the difference was not significant (80% vs. 50%, p=0.210). The relapse rate after 64 months was higher in the high PLA2R-AB group (87% vs. 63%). Multivariant linear regression found serum creatinine (ß=0.682, p<0.001) and PLA2R-AB (ß=0.527, p<0.001) as significant predictors for kidney function at the end of follow-up. Conclusion: higher titers of PLA2R-AB are related to worse kidney function outcome, higher 24-hour proteinuria, and a higher number of relapses in patients with pMN.