Clinical Observation of Serum Anti-PLA2R Antibody Levels in the Treatment of Idiopathic Membranous Nephropathy with Rituximab

Objective: To investigate the efficacy of rituximab in the treatment of idiopathic membranous nephropathy with varying levels of serum phospholipase A2 receptor antibodies. Methods: A total of 137 patients with idiopathic membranous nephropathy admitted to Beijing Sixth Hospital were selected. Based on their blood PLA2R antibody levels before rituximab treatment, patients were categorized into the PLA2R antibody positive group (n = 94) and the PLA2R antibody negative group (n = 43). They were followed up for at least 1 year, during which the efficacy, measured through 24-hour urine protein quantification and serum albumin levels, were compared between the two groups before and after treatment. Results: After 3 months of treatment, there was no significant difference in the quantitative levels of 24-hour urine protein between the two groups (P > 0.05). However, after 6 and 12 months of treatment, there was a significant difference in the levels of 24-hour urine protein between the two groups (P < 0.05). Additionally, after 3 months of treatment, there was a notable difference in the serum albumin levels between the two groups (P < 0.05). However, after 6 and 12 months of treatment, there was no significant difference in serum albumin levels between the two groups (P > 0.05). Analysis of complications in the two groups revealed that in the positive group, 9 individuals experienced thrombosis, 5 had infections, and 11 developed acute kidney injury (AKI). In contrast, in the negative group, 5 individuals had thrombosis, 2 had infections, and 3 developed AKI. There was no statistically significant difference in complications between the two groups (P > 0.05). Conclusion: Serum anti-PLA2R antibody levels provide valuable insights into the clinical observation of rituximab treatment for idiopathic membranous nephropathy. They aid in understanding the disease’s pathogenesis, evaluating treatment efficacy, and predicting disease prognosis.