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Phospholipase A2 receptor antibodies and clinical prognosis in patients with idiopathic membranous nephropathy: an updated systematic review and meta-analysis

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机构: [1]Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing, China [2]The National Clinical Research Center for Geriatric Disease, Xuanwu Hospital, Capital MedicalUniversity, Beijing, China
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关键词: PLA2R-ab idiopathic membranous nephropathy complete remission partial remission spontaneous remission

摘要:
Background: Idiopathic membranous nephropathy (IMN) is the most common form of primary nephrotic syndrome in adults. Antibodies against the M-type phospholipase A2 receptor (PLA2R-ab) are considered as diagnostic biomarkers of IMN. Objective: Here, we performed an updated meta-analysis to assess the diagnostic value of PLA2R-ab for clinical remission in IMN patients. Method: PubMed, Embase and Cochrane databases were searched for relevant studies published before September 2022. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were determined using a fixed or random effects model. The heterogeneity among studies was explored by subgroup analysis. Results: Sixteen studies involving 1761 IMN participants were included. There were significant differences between PLA2R-ab (+) and PLA2R-ab (-) patients in terms of complete remission (CR) and spontaneous remission. The rates of partial remission (PR) and relapse were similar between the two groups. Patients with PLA2R-ab (-) were at a higher CR rate when treated with a calcineurin inhibitor or a treatment course for 3 months and 6 months, while the spontaneous remission rate was higher in PLA2R-ab seronegative patients from Asia. However, the CR and spontaneous remission rate only significantly declined in IMN patients with the highest titer, but not a middle titer, when compared to those with the lowest titer. Conclusion: In contrast to previous meta-analyses, our results verified that PLA2R-ab can likely predict CR and spontaneous remission in IMN patients, instead of PR and relapse. Race, immunosuppressive agents and duration of treatment may affect the prognostic value of PLA2R-ab. Considering that the remission rate of IMN patients with a middle level of PLA2R-ab was not different from that of patients with the lowest level, a proper cut-off value of PLA2R-ab for prognosis should be clarified.

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基金编号: 202110025038 81570663

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出版当年[2022]版:
大类 | 4 区 医学
小类 | 3 区 泌尿学与肾脏学 4 区 外周血管病 4 区 生理学
最新[2023]版:
大类 | 4 区 医学
小类 | 3 区 生理学 4 区 外周血管病 4 区 泌尿学与肾脏学
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出版当年[2021]版:
Q2 PHYSIOLOGY Q2 UROLOGY & NEPHROLOGY Q3 PERIPHERAL VASCULAR DISEASE
最新[2023]版:
Q2 PERIPHERAL VASCULAR DISEASE Q2 UROLOGY & NEPHROLOGY Q3 PHYSIOLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2021版] 出版当年五年平均 出版前一年[2020版] 出版后一年[2022版]

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第一作者机构: [1]Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing, China
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通讯机构: [1]Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing, China [2]The National Clinical Research Center for Geriatric Disease, Xuanwu Hospital, Capital MedicalUniversity, Beijing, China
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