The association of anti-PLA2R with clinical manifestations and outcomes in idiopathic membranous nephropathy: a meta-ana

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NEPHROLOGY - ORIGINAL PAPER

The association of anti‑PLA2R with clinical manifestations and outcomes in idiopathic membranous nephropathy: a meta‑analysis Si‑jie Rao1 · Qing Shen1 · Hong‑mei Wang2 · Shi Tang1 · Xiang‑yan Wang1 Received: 11 March 2020 / Accepted: 27 July 2020 © Springer Nature B.V. 2020

Abstract Purpose  The meta-analysis aims to investigate the relationship between anti-phospholipase A2 receptor autoantibody (antiPLA2R) and clinical characteristics and adverse outcomes of idiopathic membranous nephropathy (IMN). Methods  Related studies published before February 2020 were systematically retrieved from foreign and domestic databases, RevMan5.3 software was used for meta-analysis and subgroup analysis, and STATA 15.0 statistical software was used for its heterogeneity and testing publication bias. Results  Twenty studies were included, involving 2224 patients with IMN. Our results showed that a significant correlation existed between the expression of serum anti-PLA2R and age (MD = 2.91, 95% CI = 2.15–3.67, P  16 U/ml > 14 RU/ml > 14 U/ml > 20 U/ml > 20 U/ml > 20 U/ml 1:100 1:500 > 20 U/ml > 20 U/ml 1:50

– 34 16 164

79 34 25 41 69 65 81 69 25 94 93 – – 16 387 –

145 45 – –

– – – – – – – – – – – 100 78 – 514 40

7 8 8 7

8 7 7 8 7 7 7 7 8 7 7 7 7 7 7 7

Follow-up (month) Cutoff value Serum(+) Renal(+) NOS score

 The unit for Alb, 24HTP, CREA, eGFR, CHO, UPCR: g/dl, g/24 h, mg/dl, ml/min per 1.73 m2, mg/dl, g/g

a,b,c,d,e,f,g

A Asian, NA none Asian, M/F male/female

IST or RTX the percentage of people receiving immunosuppressive or rituximab therapy, serum(+) or renal(+): the number of patients whose anti-PLA2R is positive in serum or renal tissue

NA NA NA A A NA NA NA A A A A A NA A A

Race Sample (M/F) Extractable baseline parameters

Hofstra/2012 Bech/2014 Beck/2011 Kim/2015 Oh/2013 Timmermans/2015 Ruggenenti/2015 Pourcine/2017 Song/2018 Ramachandran/2016 Wei SY/2016 Liu Hong/2016 Wang Jia/2017 Hoxha/2014 Huazhang/2016 Wang Lj/2016

Author/time

Table 1  Characteristics of eligible studies

International Urology and Nephrology

International Urology and Nephrology

studies, respectively, demonstrated the relationship between serum titer and clinical unremission, baseline characteristics, and poor prognosis. The median follow-up period exceeding 12 months accounted for 90%, but the rate of lost to followup reached up to 20%.

Relationship between anti‑PLA2R and clinical characteristics The results in Table  2 summarized the relationship between the expression of anti-PLA2R and the clinical baseline characteristics of patients with IMN. It showed that the mean age (MD = 2.91, 95% CI = 2.15–3.67, P