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dc.contributor.authorJatem Escalante, Elias
dc.contributor.authorMartín Conde, María Luisa
dc.contributor.authorGracia-Lavedan, Esther
dc.contributor.authorBenítez, Iván
dc.contributor.authorGonzález, Jorge
dc.contributor.authorColàs Campàs, Laura
dc.contributor.authorGarcia Carrasco, Alicia
dc.contributor.authorMartínez Martínez, Cristina
dc.contributor.authorSegarra Medrano, Alfons
dc.description.abstractBackground: In anti-phospholipase A2 receptor (PLA2R) membranous nephropathy (MN) there is controversy whether spontaneous remission (SR) can be predicted using a single titre or by assessing the dynamic changes in anti-PLA2R antibody (ab) titres. The study objective was to identify the optimal dynamics of anti-PLA2Rab titres to predict SR in MN. Methods: A total of 127 nephrotic patients with anti-PLA2R-MN were prospectively followed up for 6 months under conservative treatment. Anti-PLA2Rabs and proteinuria were assessed at diagnosis and monthly thereafter. The primary endpoint (PEP) was a reduction of proteinuria ≥50% at 6 months. Logistic models with baseline and evolutive anti-PLA2Rab titres were developed to predict the PEP. Results: A total of 28 patients (22%) reached the PEP. These patients were more frequently female and had significantly lower baseline proteinuria and anti-PLA2Rab titres. An anti-PLA2R titre ≤97.5 RU/mL at diagnosis had a sensitivity of 71% and a specificity of 81% to predict the PEP. The model including baseline anti-PLA2Rabs and a reduction ≥15% at 3 months predicted the PEP with a sensitivity of 93% and a specificity of 80%, with an area under the curve that was significantly greater than that obtained with relative changes of proteinuria in the same period of time {odds ratio [OR] 0.95 [95% confidence interval (CI) 0.91–0.98 versus OR 0.79 [95% CI 0.70–0.88], respectively; P = 0.0013}. Conclusions: Combining the baseline anti-PLA2Rab titres with their relative changes at 3 months after diagnosis gives the earliest prediction for achieving a reduction of urinary protein excretion ≥50% at 6 months in MN, thereby shortening the observation period currently recommended to make individualized decisions to start immunosuppressive therapy.ca_ES
dc.publisherEuropean Renal Association - European Dialysis and Transplant Association (ERA-EDTA)ca_ES
dc.publisherOxford University Pressca_ES
dc.relation.isformatofReproducció del document publicat a:
dc.relation.ispartofClinical Kidney Journal, Volume, 2021, vol. 14, núm. 12, p. 2556–2562ca_ES
dc.rightscc-by-nc (c) Authors, 2019ca_ES
dc.subjectAnti-PLA2R antibodiesca_ES
dc.subjectMembranous nephropathyca_ES
dc.subjectNephrotic syndromeca_ES
dc.subjectSpontaneous remissionca_ES
dc.titleMonitoring anti-PLA2R antibody titres to predict the likelihood of spontaneous remission of membranous nephropathyca_ES

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cc-by-nc (c) Authors, 2019
Except where otherwise noted, this item's license is described as cc-by-nc (c) Authors, 2019