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Serum PLA2R antibody as a predictive biomarker for venous thromboembolism risk in primary membranous nephropathy

Jiayi Li1, Xu Wang2, Shimin Jiang2

  • 1Department of Nephrology, Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China; Department of Nephrology, China-Japan Friendship Hospital, Beijing, China.

Medicina Clinica
|August 2, 2023
PubMed
Abstract

Insights

Phospholipase A2 receptor (PLA2R) antibodies predict venous thromboembolism (VTE) risk in primary membranous nephropathy (PMN) patients with serum albumin >25g/l. This finding aids in stratifying VTE risk for better patient management.

Area of Science:

  • Nephrology
  • Immunology
  • Cardiology

Background:

  • Patients with nephrotic syndrome, particularly primary membranous nephropathy (PMN), face a high risk of venous thromboembolism (VTE).
  • Phospholipase A2 receptor (PLA2R) antibodies are recognized biomarkers for PMN activity.
  • The association between PLA2R antibodies and VTE risk in PMN requires further investigation.

Purpose of the Study:

  • To investigate the predictive value of serum PLA2R antibodies in patients with PMN for the occurrence of VTE.
  • To determine if PLA2R antibody status can stratify VTE risk in PMN patients, especially those with specific albumin levels.

Main Methods:

  • A retrospective study included 97 patients with PMN.
  • VTE events were assessed using lower extremity venous ultrasound, renal vein ultrasound, or CT pulmonary arteriography.
  • Serum anti-PLA2R antibodies were measured via ELISA, and VTE risk was stratified by serum albumin levels.

Main Results:

  • Twenty PMN patients (21%) experienced thromboembolic events.
  • Among patients with serum albumin >25g/l, 8 (15%) developed VTE, with 6 testing positive for PLA2R antibodies.
  • Positive PLA2R antibodies were significantly associated with VTE in patients with serum albumin >25g/l (p=0.01), and Kaplan-Meier analysis showed a higher VTE probability in anti-PLA2R positive patients.

Conclusions:

  • Serum PLA2R antibody positivity serves as a significant risk predictor for thromboembolic events in primary membranous nephropathy patients with serum albumin >25g/l.
  • This finding can help identify high-risk individuals for targeted VTE prophylaxis and management strategies.
Keywords:
Anti-PLA2R antibodyAnticuerpo anti-PLA2REmbolia pulmonarNefropatía membranosa primariaPrimary membranous nephropathyPulmonary embolismTrombosis venosaVenal thrombosis

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