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BMC Nephrology

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Open Access 01-12-2017 | Research article

Response to immunosuppressive therapy in PLA₂R- associated and non-PLA₂R- associated idiopathic membranous nephropathy: a retrospective, multicenter cohort study

Authors: Jia Wang, Qionghong Xie, Zhuxing Sun, Ningxin Xu, Yan Li, Liang Wang, Shaojun Liu, Jun Xue, Chuan-Ming Hao

Published in: BMC Nephrology | Issue 1/2017

Abstract

Background

According to renal M type phospholipase A₂ receptor (PLA₂R) immunohistochemistry, idiopathic membranous nephropathy (IMN) could be categorized into PLA₂R-associated and non-PLA₂R-associated IMN. We conducted a retrospective, multicenter cohort study with 91 patients to compare the effect of immunosuppressive therapy between PLA₂R-associated and non-PLA₂R-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 PLA₂R immunohistochemistry in kidney biopsies were designated as PLA₂R-associated IMN. Seventy-eight of the 91 IMN patients was PLA₂R-associated IMN and 13 were non-PLA₂R-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-PLA₂R-associated group than in the PLA₂R-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-PLA₂R-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 PLA₂R-associated group and none in non-PLA₂R-associated group, although there was no significant difference between these two groups.

Conclusion

Compared with the PLA₂R-associated IMN, the non-PLA₂R-associated IMN responded quicker to the immunosuppressive therapy.

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Title: Response to immunosuppressive therapy in PLA2R- associated and non-PLA2R- associated idiopathic membranous nephropathy: a retrospective, multicenter cohort study
Authors: Jia Wang
Qionghong Xie
Zhuxing Sun
Ningxin Xu
Yan Li
Liang Wang
Shaojun Liu
Jun Xue
Chuan-Ming Hao
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: BMC Nephrology / Issue 1/2017
Electronic ISSN: 1471-2369
DOI: https://doi.org/10.1186/s12882-017-0636-0

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Response to immunosuppressive therapy in PLA₂R- associated and non-PLA₂R- associated idiopathic membranous nephropathy: a retrospective, multicenter cohort study

Abstract

Background

Methods

Results

Conclusion

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