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2017 ; 18
(1
): 227
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English Wikipedia
Response to immunosuppressive therapy in PLA(2)R- associated and non-PLA(2)R-
associated idiopathic membranous nephropathy: a retrospective, multicenter cohort
study
#MMPMID28693446
Wang J
; Xie Q
; Sun Z
; Xu N
; Li Y
; Wang L
; Liu S
; Xue J
; Hao CM
BMC Nephrol
2017[Jul]; 18
(1
): 227
PMID28693446
show ga
BACKGROUND: According to renal M type phospholipase A(2) receptor (PLA(2)R)
immunohistochemistry, idiopathic membranous nephropathy (IMN) could be
categorized into PLA(2)R-associated and non-PLA(2)R-associated IMN. We conducted
a retrospective, multicenter cohort study with 91 patients to compare the effect
of immunosuppressive therapy between PLA(2)R-associated and
non-PLA(2)R-associated IMN patients. METHODS: A total of 91 biopsy-proven IMN
patients from Huashan hospital and People's Hospital of Wuxi in past 5 years were
collected into this study. IMN with positive PLA(2)R immunohistochemistry in
kidney biopsies were designated as PLA(2)R-associated IMN. Seventy-eight of the
91 IMN patients was PLA(2)R-associated IMN and 13 were non-PLA(2)R-associated
IMN. Forty-five patients were treated with prednisone plus cyclophosphamide
(CTX), and 46 with prednisone plus calcineurin inhibitors (CNIs). The follow-up
duration was 15 months. RESULTS: The total remission rate (76.9% versus 44.9%,
p = 0.032) and complete remission rate (30.8% versus 2.6%, p = 0.003) were both
significantly higher in the non-PLA(2)R-associated group than in the
PLA(2)R-associated group at the 3rd month visit point, and at the 6th month time
point, the complete remission rate was still significantly higher in the
non-PLA(2)R-associated group (46.2% versus 11.5%,p = 0.007). But similar
remission rates were found after the 9th month. Relapses were observed in 8
patients in PLA(2)R-associated group and none in non-PLA(2)R-associated group,
although there was no significant difference between these two groups.
CONCLUSION: Compared with the PLA(2)R-associated IMN, the non-PLA(2)R-associated
IMN responded quicker to the immunosuppressive therapy.