Correlation between urinary concentration of phospholipase A2 receptor and clinical characteristics and prognosis of idiopathic membranous nephropathy patients

Objective To explore the relationship of urinary concentration of phospholipase A2receptor(PLA2R)with clinical severity of idiopathic membranous nephropathy(IMN)patients and analyze its value in IMN disease assessment and prognosis.Methods From December 2017 to December2018,a retrospective reviewed for 38 IMN patients confirmed by kidney biopsy. Urinary concentration of PLA2R was detected by enzyme-linked immunosorbent assay(ELISA)and partial correlation method employed for examining the correlation between urinary PLA2R concentration and clinical data. The predictive value of urinary PLA2R concentration for complete remission of proteinuria within 6 months was evaluated by receiver operating characteristic curve and Logistic regression analysis.Results Partial correlation analysis indicated that urinary concentration of PLA2R——a median of 0.061 μg/L——was negatively correlated with baseline estimated glomerular filtration rate(eGFR)(r_s=-0.507,P=0.002)and serum albumin(r_s=-0.464,P=0.004);positively correlated with 24h total urinary protein(r_s=0.700,P<0.001).During 6-month follow-ups,urinary PLA2R concentration was significantly lower proteinuria in complete remission group than that in non-complete remission group0.024(0.012,0.057)μg/L vs 0.102(0.041,0.326)μg/L,P=0.008. Multivariate Logistic regression analysis showed that urinary concentration of PLA2R was an independent predictor of complete remission of proteinuria within 6 monthsOR=0.053(0.003-0.865),P=0.039.Conclusion Positively correlated with the severity of IMN patients,urinary PLA2R concentration may independently predict a complete remission of proteinuria within 6 months.