Membranous nephropathy in a Russian population

Добронравов, В. А.; Mayer, D A; Berezhnaya, O V; Лапин, С. В.; Мазинг, А. В.; Sipovsky, V G; Смирнов, А В

doi:10.17116/terarkh201789621-29

Ter. arkh.

2017

DOI: 10.17116/terarkh201789621-29

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Membranous nephropathy in a Russian population

В. А. Добронравов¹,

D A Mayer²,

O V Berezhnaya³

et al.

Abstract: In Russia, PMN is a common type of glomerulopathy, the specific features of which should include the low rates of spontaneous remissions and detection of anti-PLA2R Abs. For renal protection, the majority of patients with PMN require timely diagnosis and treatment; individualization of the choice of treatment and its enhanced efficiency call for further investigations.

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Cited by 2 publications

References 59 publications

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Membranous nephropathy: the current state of the problem

Sharapov

Abdullaev

2023

KIDNEYS

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Membranous nephropathy (MN) is an autoimmune disease of the kidney glomeruli and one of the leading causes of nephrotic syndrome. The disease exhibits heterogenous outcomes with approximately 30 % of cases progressing to end-stage renal disease. The study of MN pathogenesis has steadily advanced owing to the identification of autoantibodies to the phospholipase A2 receptor (PLA2R) in 2009 and thrombospondin domain-containing 7A (THSD7A) on the podocyte surface in 2014. Approximately 50–80 and 3–5 % of primary MN cases are associated with either anti-PLA2R or anti-THSD7A antibodies, respectively. The presence of these autoantibodies is used for MN diagnosis; antibody levels correlate with disease severity and possess significant biomarker values in monitoring disease progression and treatment response.

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Membranous nephropathy: the current state of the problem

Sharapov

Abdullaev

2023

KIDNEYS

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A novel approach to rapid induction of remission in primary membranous nephropathy

Добронравов

Bystrova

Kochoyan

et al. 2021

Terapevticheskii arkhiv

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Aim. То evaluate the effectiveness of a novel multi-targeted treatment approach including rituximab (RTX), cyclophosphamide (CPH) and steroids (S) to the induction of remission in patients with primary membranous nephropathy (PMN) compared to standard immunosuppression (IST). Materials and methods. An open-label prospective comparative study included 56 PMN patients (pts) with nephrotic syndrome (NS) and high serum level of antibodies to the phospholipase A2 receptor anti-PLA2R (mean age 5112 years, men 70%). We recorded demographic and clinical parameters at the time of kidney biopsy, data from light-optical and immunomorphological studies. All pts were on stable doses of the renin-angiotensin systems blockers. We compared the effectiveness of different treatments in the inductions of clinical and immunological remissions in pts who received experimental treatment with RTX, CPH and S (RTX+CPH+S group, n=14) and two control groups: high-dose RTX therapy (group RTX, n=12), cyclosporine and steroids (group CsA+S, n=30). Results. In the RTX+CPH+S group, remission was achieved in 100% of cases (of which complete remissions CR in 21.4%). The median time-to-remission (2.5 [1.0; 3.5] months) was significantly lower compared to both control groups: RTX (8.7 [6.6; 14.0] months, p=0.005) and CsA+S (12.4 [6.5; 19.9] months, p0.001). The cumulative incidence of clinical and immunological remissions was also significantly higher in the RTX+CPH+S group than in the control groups. These results were confirmed in comparative analyzes in the same treatment groups after propensity score matching. The cumulative incidence of clinical and immunological remissions in the RTX+CPH+S group was higher than in the combined group of patients who received other therapies (p0.001). The incidence of serious adverse events was low and did not differ between groups. Conclusion. The use of multi-targeted therapy with rituximab, cyclophosphamide, and steroids seems to be an effective approach for the rapid induction of PMN remission and prevention of NS complications.

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Membranous nephropathy in a Russian population

Cited by 2 publications

References 59 publications

Membranous nephropathy: the current state of the problem

Membranous nephropathy: the current state of the problem

A novel approach to rapid induction of remission in primary membranous nephropathy

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