The Clinicopathological Features of Patients with Membranous Nephropathy

Overview

Journal Int J Nephrol Renovasc Dis

Publisher Dove Medical Press

Specialty Nephrology

Date 2018 Feb 7

PMID 29403303

Citations 3

Authors

Hanyu Zhu

Qiuxia Han

Dong Zhang

Yong Wang

Jing Gao

Xiaoli Yang

Wenjia Geng

Xiangmei Chen

Affiliations

Soon will be listed here.

Abstract

Background: Membranous nephropathy (MN) represents a distinct glomerular disease which has been considered as a major cause of nephrotic syndrome (NS) in adults. Evidences show that the clinicopathological features of MN are various among MN cases. This study aimed to summarize and analyze the clinicopathological features of patients with MN.

Methods: A total of 231 MN patients were recruited in this study. Their clinical and pathological features were collected and analyzed according to their age, gender, pathological stages, and anti-phospholipase A2 receptor (anti-PLA2R) antibodies tests.

Results: Among the 231 MN cases, the ratio of male to female was 1.47 and the mean age was 47.43±14.32 years. Altogether, 163 (70.6%) cases were positive for NS. Their serum antiPLA2R, body mass index, total cholesterol, triglyceride, low density lipoprotein cholesterol, D2, IgA, and IgE were increased, but IgG was decreased. The majority of the patients were middle aged and old aged. In addition, the pathological stage was significantly correlated with gender (=0.038), creatinine, (=0.021) and IgE (=0.003). A total of 74.9% MN patients were found to be positive for anti-PLA2R antibodies, and they were more likely to have abnormal serum indices.

Conclusion: The major clinicopathological characteristics of MN patients are summarized in this study. Male and elder MN cases are likely to have rapid disease progression. Advanced pathological stages and being positive for anti-PLA2R antibodies may be potential indicators for disease activity of MN.

Citing Articles

Changes in the spectrum of kidney diseases: a survey of 2803 patients from 2010 to 2018 at a single center in southeastern China.

Zheng L, Tu L, Huang H, Zhang L, Wang Y, Zhou J Ren Fail. 2022; 44(1):987-993.

PMID: 35656734 PMC: 9176642. DOI: 10.1080/0886022X.2022.2083517.

The Diagnostic and Prognostic Potential of the B-Cell Repertoire in Membranous Nephropathy.

Su Z, Jin Y, Zhang Y, Guan Z, Li H, Chen X Front Immunol. 2021; 12:635326.

PMID: 34122405 PMC: 8190383. DOI: 10.3389/fimmu.2021.635326.

Clinical value of a serum anti-PLA2R antibody in the diagnosis and monitoring of primary membranous nephropathy in adults.

Wu X, Liu L, Guo Y, Yang L Int J Nephrol Renovasc Dis. 2018; 11:241-247.

PMID: 30288080 PMC: 6159797. DOI: 10.2147/IJNRD.S176665.

References

Ponticelli C, Passerini P . Can prognostic factors assist therapeutic decisions in idiopathic membranous nephropathy?. J Nephrol. 2010; 23(2):156-63. View

Praga M, Rojas-Rivera J . Glomerular disease: Predicting outcomes in idiopathic membranous nephropathy. Nat Rev Nephrol. 2012; 8(9):496-8. DOI: 10.1038/nrneph.2012.161. View

Gandolfo M, Verzola D, Salvatore F, Gianiorio G, Procopio V, Romagnoli A . Gender and the progression of chronic renal diseases: does apoptosis make the difference?. Minerva Urol Nefrol. 2004; 56(1):1-14. View

Cravedi P, Abbate M, Gagliardini E, Galbusera M, Buelli S, Sabadini E . Membranous nephropathy associated with IgG4-related disease. Am J Kidney Dis. 2011; 58(2):272-5. DOI: 10.1053/j.ajkd.2011.05.002. View

Wang Y, Wang G, Li B, Chen Q . Clinicopathological analysis of idiopathic membranous nephropathy in young adults. Genet Mol Res. 2015; 14(2):4541-8. DOI: 10.4238/2015.May.4.12. View

Ayalon R, Beck Jr L . Membranous nephropathy: not just a disease for adults. Pediatr Nephrol. 2013; 30(1):31-9. PMC: 4074564. DOI: 10.1007/s00467-013-2717-z. View

Yamamoto S, Inaba S, Yoshida R, Takahashi T, Ishihara S, Sakai Y . Clinicopathological characteristics of the focal and segmental form of idiopathic membranous nephropathy: comparison with the typical form of this disease. Acta Paediatr Jpn. 1997; 39(3):349-53. DOI: 10.1111/j.1442-200x.1997.tb03751.x. View

Chen X, Chen Y, Shi K, Lv Y, Tong H, Zhao G . Comparison of prognostic, clinical, and renal histopathological characteristics of overlapping idiopathic membranous nephropathy and IgA nephropathy versus idiopathic membranous nephropathy. Sci Rep. 2017; 7(1):11468. PMC: 5597578. DOI: 10.1038/s41598-017-11838-1. View

Shiiki H, Saito T, Nishitani Y, Mitarai T, Yorioka N, Yoshimura A . Prognosis and risk factors for idiopathic membranous nephropathy with nephrotic syndrome in Japan. Kidney Int. 2004; 65(4):1400-7. DOI: 10.1111/j.1523-1755.2004.00518.x. View

10.

Ronco P, Debiec H . Pathophysiological advances in membranous nephropathy: time for a shift in patient's care. Lancet. 2015; 385(9981):1983-92. DOI: 10.1016/S0140-6736(15)60731-0. View

11.

Ponticelli C, Glassock R . Glomerular diseases: membranous nephropathy--a modern view. Clin J Am Soc Nephrol. 2013; 9(3):609-16. PMC: 3944756. DOI: 10.2215/CJN.04160413. View

12.

Beck Jr L, Bonegio R, Lambeau G, Beck D, Powell D, Cummins T . M-type phospholipase A2 receptor as target antigen in idiopathic membranous nephropathy. N Engl J Med. 2009; 361(1):11-21. PMC: 2762083. DOI: 10.1056/NEJMoa0810457. View

13.

Dai H, Zhang H, He Y . Diagnostic accuracy of PLA2R autoantibodies and glomerular staining for the differentiation of idiopathic and secondary membranous nephropathy: an updated meta-analysis. Sci Rep. 2015; 5:8803. PMC: 4350087. DOI: 10.1038/srep08803. View

14.

Chen Y, Schieppati A, Chen X, Cai G, Zamora J, Giuliano G . Immunosuppressive treatment for idiopathic membranous nephropathy in adults with nephrotic syndrome. Cochrane Database Syst Rev. 2014; (10):CD004293. PMC: 6669245. DOI: 10.1002/14651858.CD004293.pub3. View

15.

Zhang Q, Huang B, Liu X, Liu B, Zhang Y, Zhang Z . Ultrasensitive Quantitation of Anti-Phospholipase A2 Receptor Antibody as A Diagnostic and Prognostic Indicator of Idiopathic Membranous Nephropathy. Sci Rep. 2017; 7(1):12049. PMC: 5608894. DOI: 10.1038/s41598-017-12014-1. View

16.

Wu X, Wen S, Zhu X, Yuan S, Xu X, Yang D . [Diagnostic value of renal phospholipase A2 receptor and serum anti-phospholipase A2 receptor antibody in membranous nephropathy]. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2017; 42(4):395-399. DOI: 10.11817/j.issn.1672-7347.2017.04.005. View

17.

Hofstra J, Fervenza F, Wetzels J . Treatment of idiopathic membranous nephropathy. Nat Rev Nephrol. 2013; 9(8):443-58. DOI: 10.1038/nrneph.2013.125. View

18.

Hoxha E, Harendza S, Pinnschmidt H, Panzer U, Stahl R . M-type phospholipase A2 receptor autoantibodies and renal function in patients with primary membranous nephropathy. Clin J Am Soc Nephrol. 2014; 9(11):1883-90. PMC: 4220763. DOI: 10.2215/CJN.03850414. View

19.

Ponticelli C, Passerini P . Management of idiopathic membranous nephropathy. Expert Opin Pharmacother. 2010; 11(13):2163-75. DOI: 10.1517/14656566.2010.494599. View

20.

Tan Y, Yang D, Fan J, Chen Y . Elevated levels of immunoglobulin E may indicate steroid resistance or relapse in adult primary nephrotic syndrome, especially in minimal change nephrotic syndrome. J Int Med Res. 2012; 39(6):2307-13. DOI: 10.1177/147323001103900629. View