The value of serum anti-phospholipase A2 receptor antibody in idiopathic membranous nephropathy and its clinical relevance

Objective To investigate the value of serum anti-phospholipase A2 receptor antibody(anti-PLA2 R antibody) in the diagnosis of idiopathic membranous nephropathy(IMN), and to explore the correlation between the its titer and clinical indexes such as the level of proteinuria, estimated glomerular filtration rate, renal function and pathological stage of IMN patients. Methods The clinical and laboratory data of 79 patients with IMN diagnosed by renal biopsy from January 2014 to October 2018 in our hospital with serum anti-PLA2 R antibody test results were retrospectively analyzed. Results There were 49 cases of anti PLA2 R antibody positive in IMN patients(62.0%). The levels of total protein and albumin in positive patients were lower than those in anti-PLA2 R antibody negative IMN. Compared with the low titer anti-PLA2 R antibody group, the patients in the high titer group were older, the 24-hour urinary protein was more, and the estimated glomerular filtration rate, total protein and albumin levels were lower. Compared with the mild urinary protein group, the severe group had higher anti-PLA2 R antibody ratio, higher serum creatinine, total cholesterol, low density lipoprotein, lower estimated glomerular filtration rate, total protein and albumin. Compared with young IMN patients, the middle-aged and elderly IMN patients had higher rates of female, high titers of anti-PLA2 R antibodies, urea nitrogen, estimated glomerular filtration rate, total cholesterol and low density lipoprotein levels.The titers of serum anti-PLA2 R antibody and other laboratory indexes were not correlated with pathological stages. Conclusion The titer of serum anti PLA2 R antibody is closely related to age, urinary protein, renal function, serum total cholesterol, low density lipoprotein, serum total protein and albumin, and has a high specificity in the diagnosis of IMN.