CHANGES OF PLA2R AND NEPHRIN CONTENTS IN IDIOPATHIC MEMBRANOUS NEPHROPATHY AND THEIR CORRELATION WITH RENAL FUNCTION DAMAGE AND PODOCYTE DAMAGE

Haiyan Zheng¹, Xiaoqin Xu¹, Jumei Xia^2,*

¹Department of Nephrology, Beijing Road Medical District, General Hospital of Xinjiang Military Region, Urumqi, PR China - ²Department of Nephrology, Zengcheng District People's Hospital, Guangzhou, PR China

Objective: To study the changes of phospholipase A2 receptor (PLA2R) and nephrin in patients with idiopathic membranous nephropathy and the correlation with damage to both renal function and podocytes. 

Methods: One-hundred and twenty patients with membranous nephropathy were randomly selected from the nephrology department of our hospital from August 2018 to August 2019. According to the patients' condition, they were divided into either idiopathic (IMN) (n = 56) or secondary (SMN) (n = 64) membranous nephropathy groups. At the same time, 40 healthy people in the physical examination centre of our hospital were selected as the control group to detect and compare the content of PLA2R, nephrin, urea nitrogen (BUN), muscle in each group creatinine (Cre) and albumin (AIB) and other renal function indexes were changed. Urine of all subjects was collected, and the changes in podocyte injury indexes such as C5b-9 and PCX were detected and compared. 

Results: The serum PLA2R level of IMN patients was significantly higher than that of SMN patients and healthy controls, and the serum PLA2R level of SMN patients was significantly higher compared to healthy controls (P<0.01); The serum nephrin level of IMN patients was significantly lower than that of SMN patients and healthy controls, and the serum nephrin level of SMN patients was significantly lower than that of healthy subjects (P<0.01). The level of serum BUN and Cre in IMN patients was significantly higher than that in SMN patients and healthy controls, and the level of serum BUN and Cre in SMN patients was significantly higher than that in healthy controls (P<0.01). The serum AIB level of IMN patients was significantly lower than that of SMN patients and healthy subjects, and the difference was statistically significant (P<0.01). The serum levels of C5b-9 and PCX in IMN patients were significantly higher than those in SMN patients and healthy controls, and the serum levels of C5b-9 and PCX in SMN patients were also significantly higher compared to these controls (P<0.01). Pearson correlation analysis showed that PLA2R was positively correlated with BUN, Cre, C5b-9 and PCX (r = 0.512, 0.415, 0.345 and 0.431, respectively, P < 0.05) and negatively correlated with AIB (r = -0.652, P = 0.036). Nephrin was negatively correlated with BUN, Cre and C5b-9 (r-0.417, - 0.263, - 0.324, - 0.185, P < 0.05) and positively correlated with AIB (r = 0.418, P = 0.001). 

Conclusion: PLA2R levels in patients with IMN were found to be higher than that in healthy controls, a result that was positively correlated with renal function damage and podocyte injury; The content of nephrin was lower compared to controls and was negatively correlated with damage to both renal function and podocytes.