title: Clinical features, course and prognosis of idiopathic membranous nephropathy depending on the presence of antibodies against M-type phospholipase A2 receptor.
abstract: 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.
authors: Servicio de Nefrología, Hospital Universitari Vall d́Hebron, Universidad Autónoma de Barcelona, Barcelona, España. Electronic address: jatemelias@gmail.com.
authors: Elías
authors: E
authors: Jatem Escalante
authors: Servicio de Nefrología, Hospital Universitari Vall d́Hebron, Universidad Autónoma de Barcelona, Barcelona, España.
authors: Alfons
authors: A
authors: Segarra Medrano
authors: Servicio de Bioquímica, Hospital Universitari Vall d́Hebron, Barcelona, España.
authors: Clara
authors: C
authors: Carnicer Cáceres
authors: Unidad de Nefrología, Hospital de Poniente, El Ejido, Almería, España.
authors: M Adoración
authors: MA
authors: Martín-Gómez
authors: Servicio de Patología, Hospital Universitari Vall d́Hebron, Barcelona, España.
authors: María Teresa
authors: MT
authors: Salcedo Allende
authors: Servicio de Nefrología, Hospital Universitari Vall d́Hebron, Universidad Autónoma de Barcelona, Barcelona, España.
authors: Helena
authors: H
authors: Ostos Roldan
authors: Servicio de Nefrología, Hospital Universitari Vall d́Hebron, Universidad Autónoma de Barcelona, Barcelona, España.
authors: Irene
authors: I
authors: Agraz Pamplona
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood / Q000276:immunology*; D001324:Autoantigens / Q000276:immunology*; D001327:Autoimmune Diseases / Q000453:epidemiology; D065095:Calcineurin Inhibitors / Q000627:therapeutic use; D015897:Comorbidity; D003404:Creatinine / Q000097:blood; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D015433:Glomerulonephritis, Membranous / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology; D011379:Prognosis; D054507:Receptors, Phospholipase A2 / Q000276:immunology*; D012075:Remission, Spontaneous; D017582:Renal Replacement Therapy / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D001323:Autoantibodies; D001324:Autoantigens; D065095:Calcineurin Inhibitors; D054507:Receptors, Phospholipase A2; D003404:Creatinine
keywords: Anti-PLA2R antibodies; Anticuerpos anti-PLA2R; Idiopathic membranous nephropathy; Nefropatía membranosa idiopática; Nephrotic syndrome; Prognosis; Pronóstico; Síndrome nefrótico