Background: With the increase of diabetes, diabetes kidney disease (DKD) was increasing year by year. The pathological types of DKD were various, among which, membranous nephropathy (MN) accounts for a large proportion of nondiabetic renal diseases (NDRD). Recently, serum anti-phospholipidase A2 receptor antibody(sPLA2R-Ab) was used for the diagnosis of MN, the diagnostic efficacy of sPLA2R-Ab for MN in DKD population need to be further verified.
Methods: Screened on patients with type 2 diabetes mellitus (T2DM) who underwent a renal biopsy and have a valid sPLA2R-Ab test results, hospitalized in the general hospital of the people’s liberation army of China between May 1st, 2016 and January 30th, 2018. Eligible patients were divided into two groups according to the pathological results: MN group and non-MN group. Patients’ clinical and laboratory datas were collected. Statistical analysis was performed with SPSS20.0, and P<0.05 was considered statistically significant.
Results: The study included 252 patients: 59 (23.4%) in the MN group and 193 (76.6%) in the non-MN group. MN accounts for 38% of NDRD. The sPLA2R-Ab test results of 35 patients were positive, all of them belonged to MN group. The positive rate of sPLA2R-Ab was 59.3% in MN group and 0 in non-MN group. Patients in the MN group had a higher fasting plasma glucose, age and lower estimated glomerular filtration rate, creatinine and blood pressure as well as a shorter duration of DM than patients in the non-MN group.sPLA2R-Ab achieved a good diagnostic efficiency with a sensitivity of 59.3%, specificity of 100%, negative predictive value of 88.9% and accuracy of 90.5% for MN in DKD.
Conclusion: If the sPLA2R-Ab result of DKD patients is positive, the patient must be MN, and if the result is negative, further renal biopsy should be done. The high accuracy of sPLA2R-Ab may be substituted for renal biopsy partially in the diagnosis of MN in DKD population.
Q. Wang: None. Z. Dong: None. X. Chen: None.
