Evaluation of demographic characteristics, M type phospholipase A2 receptor antibody (anti-OLA2R) level, clinical findings and treatment regimens in patients with primary (idiopathic) membranous nephropathy

Introduction: Membranous nephropathy (MN) is among the most common causes of nephrotic syndrome in non-diabetic adults. Although MN can develop due to secondary causes, it is often seen as primary (idiopathic). Patients with primary membranous nephropathy can be classified as anti-PLA2R positive and anti-PLA2R negative cases. In this study, we aimed to investigate the differences of the two groups in terms of demographic characteristics, clinical status, treatment regimens, relaps and remission. Material and Method: 95 patients who were examined with an anti-PLA2R antibody, who was admitted to the Istanbul Medical Faculty Internal Medicine Nephrotic Syndrome Polyclinic, and whose secondary causes were excluded, were examined retrospectively. Anti PLA2R antibody results examined by the IFT or ELISA method, demographic features, laboratory results, comorbidities, treatment regimens, relaps and remission were recorded. Results: AntiPLA2R antibody was positive in 48 of the patients in the study (52.8%). There was no significant difference between anti-PLA2R antibody positive and negative groups, demographic features such as age, diagnosis age, gender distribution, clinical findings such as edema hematuria and comorbidities (p ˃ 0.05). There were no significant differences in total protein, albumin, creatine, glucose, total cholesterol, triglyceride, GFR, proteinuria values before and after treatment (p ˃ 0.05). Serum creatinine value was significantly higher treatment in the group with positive anti-PLA2R antibody than the negative group (p <0.035). In the group with anti-PLA2R antibody positive, total immunosuppressive therapy (p<0.008), corticosteroid (p <0.004), cyclosporin (p <0.004), rituximab (p <0.001) use were significantly higher than the negative group while no difference was found in other treatments (p ˃ 0.05). The remission distribution and relapse status did not differ statistically in both groups. Conclusion: The precence and titer of anti-PLA2R antibodies may be guiding in the diagnosis, follow-up, individualization of the treatment and prognosis of MN.