The Value of Peripheral Blood Cell Ratios in Primary Membranous Nephropathy: A Single Center Retrospective Study
Ai-Hua Zhang1, Guang-Xia Dai2, Qi-Dong Zhang1
1Nephrology Department, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing, People's Republic of China.
Background:
Primary membranous nephropathy (PMN) is a common cause of nephrotic syndrome in adults. Forty percent of the patients continue to progress and eventually develop into chronic renal failure. Although phospholipase A2 receptor (PLA2R) is the major antigen of PMN, the clinical features do not often parallel with the antibody titers. Therefore, it is significant to find relative credible markers to predict the treatment response.
Methods:
One hundred and eighteen PMN patients were recruited. The response to treatment was defined as ALB≥30g/L at 6 months and complete remission (CR) or not at the end of the follow-up. Renal outcome endpoint was defined as 50% or more Cr increase at the end.
Results:
The patients with poor treatment effects had numerically higher platelet-lymphocytes ratio (PLR). For patients with CR or not, the difference was near to statistic significant (P=0.095). When analyzing CR or not, the fitting of the binary logistic regression model including both PLA2R Ab titer and PLR (Hosmer-Lemeshow test: χ 2=8.328, P = 0.402; OR (PLA2R Ab titer) = 1.002 (95% CI 1.000-1.004, P = 0.042); OR (PLR) = 1.006 (95% CI 0.999-1.013, P = 0.098)) was markedly better than that with only PLA2R Ab titer (Hosmer-Lemeshow test: χ 2=13.885, P = 0.016). The patients with renal function deterioration showed significantly higher monocyte-lymphocyte ratio (MLR) (0.26 (0.22-0.31) vs 0.18 (0.13-0.22), P = 0.012).
Conclusion:
PMN patients with poor treatment response tended to have higher PLR at the time of renal biopsy, and a higher MLR was associated with poor renal outcomes. Our findings suggested that PLR and MLR might be used to predict treatment efficacy and prognosis for PMN patients, respectively.
Insights
Platelet-lymphocyte ratio (PLR) and monocyte-lymphocyte ratio (MLR) may predict treatment response in primary membranous nephropathy (PMN). Higher PLR correlates with poorer treatment effects, while elevated MLR indicates worse renal outcomes in PMN patients.
Area of Science:
- Nephrology
- Immunology
- Oncology (as it relates to inflammation markers)
Background:
- Primary membranous nephropathy (PMN) is a leading cause of nephrotic syndrome in adults.
- Forty percent of PMN patients progress to chronic renal failure.
- Phospholipase A2 receptor (PLA2R) is the primary antigen, but antibody titers don't always correlate with clinical status, necessitating better predictive markers.
Purpose of the Study:
- To investigate the potential of peripheral blood cell ratios as biomarkers for predicting treatment response and renal outcomes in PMN patients.
- To evaluate the association between platelet-lymphocyte ratio (PLR) and monocyte-lymphocyte ratio (MLR) with treatment efficacy and renal function deterioration in PMN.
Main Methods:
- A cohort of 118 PMN patients was analyzed.
- Treatment response was defined by albumin levels at 6 months and complete remission (CR) at follow-up.
- Renal outcome was defined by a 50% increase in serum creatinine.
Main Results:
- Patients with poor treatment response showed numerically higher PLR.
- Logistic regression indicated that both PLA2R antibody titer and PLR improved prediction of CR.
- Significantly higher MLR was observed in patients with renal function deterioration (P=0.012).
Conclusions:
- Elevated PLR at renal biopsy may indicate a poorer response to treatment in PMN.
- Increased MLR is associated with adverse renal outcomes in PMN patients.
- PLR and MLR show promise as predictive markers for treatment efficacy and prognosis in PMN.
