TitleAnti-PLA2R Antibodies as a Prognostic Factor in PLA2R-Related Membranous Nephropathy.
Publication TypeJournal Article
Year of Publication2015
AuthorsTimmermans SAMEG, Hamid MAAbdul, Tervaert JWillem Coh, Damoiseaux JGMC, van Paassen P
Corporate AuthorsLimburg Renal Registry
JournalAm J Nephrol
Date Published2015

BACKGROUND: 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.

METHODS: 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.

RESULTS: 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

CONCLUSIONS: Low anti-PLA2R levels may predict spontaneous remissions in patients with PLA2R-related MN. Therefore, we suggest that quantification of anti-PLA2R is of value to monitor these patients.

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Alternate JournalAm. J. Nephrol.