Monitoring anti-PLA2R antibody titres to predict the likelihood of spontaneous remission of membranous nephropathy
| dc.contributor.author | Jatem Escalante, Elias | |
| dc.contributor.author | Martín Conde, María Luisa | |
| dc.contributor.author | Gracia-Lavedan, Esther | |
| dc.contributor.author | Benítez, Iván | |
| dc.contributor.author | González, Jorge | |
| dc.contributor.author | Colàs Campàs, Laura | |
| dc.contributor.author | Garcia Carrasco, Alicia | |
| dc.contributor.author | Martínez Martínez, Cristina | |
| dc.contributor.author | Segarra Medrano, Alfons | |
| dc.date.accessioned | 2022-03-22T08:43:57Z | |
| dc.date.available | 2022-03-22T08:43:57Z | |
| dc.date.issued | 2021 | |
| dc.description.abstract | Background: 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.identifier.doi | https://doi.org/10.1093/ckj/sfab116 | |
| dc.identifier.issn | 2048-8505 | |
| dc.identifier.issn | 2048-8513 | |
| dc.identifier.uri | http://hdl.handle.net/10459.1/73348 | |
| dc.language.iso | cat | ca_ES |
| dc.publisher | European Renal Association - European Dialysis and Transplant Association (ERA-EDTA) | ca_ES |
| dc.publisher | Oxford University Press | ca_ES |
| dc.relation.isformatof | Reproducció del document publicat a: https://doi.org/10.1093/ckj/sfab116 | ca_ES |
| dc.relation.ispartof | Clinical Kidney Journal, Volume, 2021, vol. 14, núm. 12, p. 2556–2562 | ca_ES |
| dc.rights | cc-by-nc (c) Authors, 2019 | ca_ES |
| dc.rights.accessRights | info:eu-repo/semantics/openAccess | ca_ES |
| dc.rights.uri | http://creativecommons.org/licenses/by-nc/4.0/ | * |
| dc.subject | Anti-PLA2R antibodies | ca_ES |
| dc.subject | Membranous nephropathy | ca_ES |
| dc.subject | Nephrotic syndrome | ca_ES |
| dc.subject | Prediction | ca_ES |
| dc.subject | Spontaneous remission | ca_ES |
| dc.title | Monitoring anti-PLA2R antibody titres to predict the likelihood of spontaneous remission of membranous nephropathy | ca_ES |
| dc.type | info:eu-repo/semantics/article | ca_ES |
| dc.type.version | info:eu-repo/semantics/publishedVersion | ca_ES |