Kidney Week

Abstract: TH-PO599

Assessment of Endothelial Dysfunction in Patient with Phospholipase A2 Receptor (PLA2R)-Positive Primary Membranous Nephropathy in Remission

Session Information

• Membranous Nephropathy, FSGS, and Minimal Change Disease
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

• 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

• Prabhu, Rishab R., Trinity Health Oakland Hospital, Pontiac, Michigan, United States

Rishab R. Prabhu, MD, MBBS

• Vojjala, Nikhil, Trinity Health Oakland Hospital, Pontiac, Michigan, United States

Nikhil Vojjala, MD, MBBS

• Prabhahar, Arun, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India

Arun Prabhahar

• Bharati, Joyita, Boston Medical Center, Boston, Massachusetts, United States

Joyita Bharati, MD

• Gorsi, Ujjwal, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India

Ujjwal Gorsi, MD, DrMed

• Rana, Pratyaksha, UN Mehta Institute of Cardiology and Research Centre, Ahmedabad, Gujarat, India

Pratyaksha Rana, MD, MBBS

• Arora, Sunil K., Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India

Sunil K. Arora, PhD

• Ramachandran, Raja, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India

Raja Ramachandran, MD, MBBS

Background

Primary membranous nephropathy (PMN) is associated with endothelial dysfunction. Emerging evidence suggests that this dysfunction persists even after clinical remission. Therefore, we aimed to study the level of endothelial dysfunction in patients with PMN in remission and compare it with healthy controls (HC) and adult podocytopathy patients in remission.

Methods

This prospective cohort study included 60 patients with Phospholipase A2 receptor (PLA2R) positive PMN in remission, all of whom had received immunosuppressive therapy at least six months prior. Endothelial dysfunction was assessed using flow-mediated vasodilation (FMD), nitroglycerin-mediated vasodilation (NMD), and CD4+CD28null T cell levels. These values were then compared with those of healthy controls.

Results

Total of 60 patients with PMN in remission were included in the study. Mean age of the patients was 43.4 years (range: 20-68). Of these, 70% (n=42) were male, and 50% (n=30) had PMN in complete remission. Mean serum creatinine level was 0.873 mg/dl (SD ± 0.2248), the mean 24-hour urinary protein was 0.873 gm/TV (SD ± 0.2248), and the mean serum albumin level was 4.152 mg/dl (SD ± 0.6473). Median FMD in PMN cases, analysed with an FDA-approved brachial analyser, was 7.45% (IQR: 2.925-12.525) (vs 6.45% (IQR=4.525-10.2) in HC (p=0.654), and the median NMD was 7.95% (IQR: 4.5-12.875) in PMN cases versus 5.89% (IQR=3.153-11.88) in HC (p=0.850). Median percentage of CD4+CD28null T cells in the PMN patients was 4.76% (IQR: 2.36-12.18) versus 5.38% (IQR: 2.26-13.09) in HC (p=0.901).

Conclusion

Patients with PMN in proteinuric and serological remission exhibit endothelial dysfunction comparable to that of healthy individuals.