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Abstract: FR-PO868

Clinical Analysis of Short-Term Therapeutic Response Factors in Membranous Nephropathy

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Iwashita, Takatsugu, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
  • Takayanagi, Kaori, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
  • Yamasaki, Maiko, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
  • Hamada, Takayuki, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
  • Ogawa, Koki, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
  • Yamamoto, Ryo, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
  • Sato, Saeko, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
  • Hida, Toru, Saitama Medical Center, Kawagoe, Japan
  • Hara, Hiroaki, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
  • Shimizu, Taisuke, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
  • Hasegawa, Hajime, Saitama Medical University School of Medicine, Kawagoe, Japan
Background

Membranous nephropathy (MN) is known to affect frequently in elderly patients.
Since the duration of MN treatment is likely to be prolonged, it is desirable that the treatment duration would be shortened by the concomitant use of immunosuppressant and prednisolone (PSL). Here, we examined clinical and histological parameters related to the rapid response to the therapy by the retrospective analysis.

Methods

Biopsy-proven 82 cases with MN, hospitalized between April 2009 and December 2017, were enrolled in this study.
All cases were divided into three groups, 1st (high responder), 2nd (middle responder) and 3rd (low responder) quantiles, based on the proteinuria-reduction ratio at a month after the beginning of therapy including sole administration of PSL and concomitant use of immunosuppressants such as Cyclosporin or Mizoribine.
Cases in 1st and 3rd quantile were comparatively studied.
All biopsy specimens were stained by anti-phospholipase A2 receptor (PLA2R) and thrombospondin type 1 domain containing 7A (THSD7A) antibodies by standard protocol.

Results

Age of 1st (n=23) and 3rd (n=24) quantile groups were 66.7±2.16 vs 66.6±3.11, showing no difference.
Estimated glomerular filtration rate (eGFR) and baseline urine protein-to-Cr ratio (PCR) in 1st quantile group were significantly higher than those in 3rd quantile group; eGFR: 72.7±2.78 vs 59.7±4.64 ml/min (p = 0.018), baseline PCR: 8.39±1.37 vs 5.09±1.11 (p = 0.039).
There was no difference in intensity of immunofluorescent staining of IgG, A, M, C3 between 1st and 3rd quantile groups.
We also studied the difference in immunofluorescent intensity of PLA2R, THSD7A and IgG subclass, however, we could not find out significant difference in the both groups.

Conclusion

Obtained results showed that higher eGFR and baseline PCR might be related to the rapid therapeutical response.
Contrary to our expectation, staining intensity of PLA2R, THSD7A and IgG subclass might not be related the rapid response to the therapy.