The relationship of soluble urokinase-type plasminogen activator receptor and phospholipase A2 receptor antibodies with glomerular injury and clinical findings in membranous glomerulonephritis and focal segmental glomerulosclerosis

ABSTRACT The relationship of Soluble Urokinase-type Plasminogen Activator Receptor and Phospholipase A2 Receptor Antibodies with Glomerular injury and Clinical Findings in Membranous Glomerulonephritis and Focal Segmental Glomerulosclerosis Aim: Membranous glomerulonephritis (GN) and focal segmental glomerulosclerosis (FSGS) constitute an important part of glomerulonephritis. Phospholipase A2 receptor antibodies (Anti-PLA2R) expressed in glomerular podocytes are important in the pathogenesis of primary membranous glomerulonephritis. High levels of soluable urokinase-type plasminogen receptor (suPAR) found in many cells, including podocytes, have been associated with glomerular injury in FSGS. Our study, aims to determine the role of anti-PLA2R and suPAR levels in the pathogenesis of membranous GN and FSGS and to evaluate their relationship with clinical parameters. Material and Methods: 20 patients with membranous GN and 20 FSGS, were diagnosed with renal biopsy who presented to Nephrology outpatient clinic of our hospital were included in our study with informed consent form and ethics committee approval. Anti-PLA2R and suPAR levels were measured in blood and urine samples from patients before the teatment was started; the correlation between age, gender, glomerular filtration rate (GFR), creatinine, 24-hour urinary proteinuria, platelet, leukocyte, albumin, C-Reactive Protein (CRP) values were evaluated. Results: % 52.5 of the patients were female and % 47.5 were male. The mean age of the participants was 42 ± 16.0 years. In the Membranous GN group, the mean albumin value was lower than the FSGS group. 90 % of patients in Membranous GN group and 55 % of patients in FSGS group had nephrotic-range proteinuria. No statistically significant difference was found between the groups in terms of plasma and urine anti-PLA2R and suPAR levels. However, Anti-PLA2R and suPAR levels were correlated with CRP, creatinin, age, and GFR. Conclusion: Anti-PLA2R and suPAR levels were correlated with clinical and laboratory findings. However, to clarify the importance of Anti-PLA2R and suPAR in Membranous GN and FSGS, studies involving more patients are needed. Keywords: Membranous glomerulonephritis, Focal segmental glomerulosclerosis, Phospholipase A2 Receptor Antibodies, Soluble Urokinase-type Plasminogen Recepto