Kidney Week

Abstract: TH-PO1004

An Indian Experience with M-Type Phospholipase A2 Receptor (PLA2R) Antibody in Membranous Nephropathy

Session Information

• Glomerular Diseases: Clinical, Outcomes, Trials - I
  October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

• 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

• Gupta, Ashwani, Sir Ganga Ram Hospital , New Delhi, New Delhi, India

Ashwani Gupta,

• Shingada, Aakash, Sir Ganga Ram Hospital , New Delhi, New Delhi, India

Aakash Shingada,

• Bhalla, Anil, Sir Ganga Ram Hospital , New Delhi, New Delhi, India

Anil Bhalla,

• Gupta, Anurag, Sir Ganga Ram Hospital , New Delhi, New Delhi, India

Anurag Gupta,

• Bhargava, Vinant, Sir Ganga Ram Hospital , New Delhi, New Delhi, India

Vinant Bhargava,

• Gaur, Lovy, Sir Ganga Ram Hospital , New Delhi, New Delhi, India

Lovy Gaur,

• Rana, Devinder S., Sir Ganga Ram Hospital , New Delhi, New Delhi, India

Devinder S. Rana,

Background

Membranous Nephropathy(MN) is one of the common cause of nephrotic syndrome in adults. We present our data, one of the first studies from India, on sensitivity of tissue and serum PLA2R in Membranous nephropathy and its association with disease activity.

Methods

Treatment-naïve biopsy-proven MN patients were included. Anti-PLA2R antibody in serum and PLA2R antigen in tissue was tested at the time of first diagnosis. Disease activity was assessed by measurement of proteinuria, serum albumin and renal function. Detailed history, examination and investigations were performed to rule out a secondary cause of MN.

Results

We included 38 patients in the study. Mean age was 45.09 +/- 14.29 yrs (27 males & 11 females). A secondary cause of MN was found in 4/38(10.5%). PLA2R (either serum or tissue) was positive in 25/38(65.8%) patients; 24/34(70.5%) in iMN and 1/4(25%) in secondary MN. Pattern of PLA2R positivity in iMN has been described in the image. PLA2R was associated with heavier proteinuria (11.27 + 5.74gm/d) vs (4.08 + 2.61gm) in patients negative for PLA2R(p<0.001) and significant hypoalbuminemia with serum albumin 2.11g/dl + 0.7g/dl in PLA2R positive patients vs 2.93 + 0.3g/dl in patients negative for PLA2R(p<0.001). No difference was found in serum creatinine between the groups (PLA2R positive - 1.03 + 0.35 mg/dl vs PLA2R negative – 0.91 + 0.29mg/dl, p - 0.3).

Conclusion

Though PLA2R is an important diagnostic tool in patients with Membranous nephropathy, yet it cannot replace biopsy, in view of moderate sensitivity as seen in our study. PLA2R is associated with heavy proteinuria and hypoalbuminemia.

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