---
title: "Anti-PLA2R Antibody Levels and Clinical Predictors of Relapse in Primary Membranous Nephropathy"
id: "frontiers-in-immunology-6-anti-pla2r-antibody-levels-and-clinical-risk-factors-for-predicting-relapse-in"
canonical_url: "https://medichelpline.com/clinical-feed/frontiers-in-immunology-6-anti-pla2r-antibody-levels-and-clinical-risk-factors-for-predicting-relapse-in"
content_type: "clinical_feed_article"
specialty: "Nephrology"
source_name: "Frontiers in Immunology"
source_url: "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1780071"
published_at: "2026-09-25T00:00:00.000Z"
evidence_level: "Journal Feed"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Anti-PLA2R Antibody Levels and Clinical Predictors of Relapse in Primary Membranous Nephropathy
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/frontiers-in-immunology-6-anti-pla2r-antibody-levels-and-clinical-risk-factors-for-predicting-relapse-in
- **Specialty:** [Nephrology](https://medichelpline.com/clinical-feed/nephrology.md)
- **Primary Source:** Frontiers in Immunology
- **Source URL:** [Original Journal Publication](https://www.frontiersin.org/articles/10.3389/fimmu.2026.1780071)
- **Published At:** 2026-09-25T00:00:00.000Z
- **Evidence Rating:** Journal Feed
## Executive GIST (TL;DR)
- This single-center retrospective cohort included 154 patients with biopsy-proven **primary membranous nephropathy (pMN)** and baseline anti-PLA2R ≥ 14 RU/mL, followed for a median 26 months. - Ninety-six patients (62.34%) achieved remission (partial or complete) within 12 months; of these, 17 (17.71%) relapsed during follow-up. Median time from treatment initiation to relapse was 23 months and median time from documented remission to relapse was 15.5 months. - Baseline anti-**PLA2R** antibody titers were significantly higher in patients who later relapsed versus those who did not (median 71.00 vs. 37.00 RU/mL; p < 0.001). - In a 3-month landmark multivariable Cox model, **anti-PLA2R seropositivity at 3 months** (≥ 14 RU/mL) was independently associated with a markedly increased risk of subsequent relapse (HR 9.44, 95% CI 2.69–33.21; p < 0.001). - A larger increase in **serum albumin** from baseline to 3 months was independently associated with a lower relapse risk (HR 0.85 per unit increase, 95% CI 0.74–0.98; p = 0.03). - The 3-month landmark model showed superior predictive performance compared with the 6-month model (AIC 123.41 vs. 138.84; Harrell’s C-index 0.83 vs. 0.66). - Remission-group baseline characteristics: lower proteinuria, lower serum creatinine, higher eGFR, higher serum albumin and globulin, and lower anti-PLA2R titers than non-remission patients. - Treatment regimens included rituximab (RTX), cyclophosphamide plus glucocorticoids (CTX+GC), and calcineurin inhibitors ± glucocorticoids (CNI ± GC); antibody measurements used a commercial assay with a cutoff of 14 RU/mL. - Authors conclude that persistent **anti-PLA2R seropositivity** and a blunted early increase in serum albumin at 3 months are potential risk factors for relapse after remission in pMN and call for larger-scale validation studies.
## Clinical Analysis & Structured Key Points
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