Jatem Escalante Elías, Segarra Medrano Alfons, Carnicer Cáceres Clara, Martín-Gómez M Adoración, Salcedo Allende María Teresa, Ostos Roldan Helena, Agraz Pamplona Irene
Servicio de Nefrología, Hospital Universitari Vall d́Hebron, Universidad Autónoma de Barcelona, Barcelona, España.
Servicio de Nefrología, Hospital Universitari Vall d́Hebron, Universidad Autónoma de Barcelona, Barcelona, España.
Nefrologia. 2015;35(5):479-86. doi: 10.1016/j.nefro.2015.05.026. Epub 2015 Jul 7.
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.
To assess potential differences in initial clinical profile, course and prognosis of idiopathic membranous nephropathy depending on the presence of anti-PLA2R antibodies.
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.
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.
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.
在膜性肾病中，抗M型磷脂酶A2受体抗体的存在被认为对特发性形式具有高度特异性。然而，尚未发现此类抗体与特定临床特征有特异性关联。
评估根据抗磷脂酶A2受体（anti-PLA2R）抗体的存在情况，特发性膜性肾病在初始临床特征、病程和预后方面的潜在差异。
纳入85例特发性膜性肾病患者（55例anti-PLA2R阳性和30例anti-PLA2R阴性）。在诊断时记录临床、生化和病理变量。记录自发缓解的频率、一线治疗反应的发生率、复发的频率和次数、无肾脏替代治疗的肾功能存活率、无慢性肾功能不全的肾功能存活率以及随访期间恶性、感染或自身免疫性疾病的发生频率。
在诊断时，anti-PLA2R阴性患者年龄显著更大，自发缓解频率更高。在一线治疗反应、复发频率和次数、无肾脏替代治疗的肾功能存活率或无慢性肾功能不全的肾功能存活率方面未观察到差异。
特发性膜性肾病的anti-PLA2R阴性患者比anti-PLA2R阳性患者年龄更大，且更常出现自发缓解。两组患者在治疗反应、复发情况及最终预后方面未观察到差异。
