Publications by authors named "P E C Brenchley"
Background And Hypothesis: The PLA2R antibody test is a valuable first-line diagnostic tool for primary membranous nephropathy (MN), helping to identify PLA2R-related MN and potentially eliminating the need for a kidney biopsy in some individuals. By reducing the reliance on biopsies, the test streamlines diagnosis and improves patient care. However, determining the optimal PLA2R measurement method and cut-off is critical to maximising the benefits of the test and minimising any harms.
View Article and Find Full Text PDFBackground: The 2021 Kidney Disease Improving Global Outcomes (KDIGO) guidelines recommend following anti-phospholipase A2 receptor (PLA2R) antibody levels as a marker of treatment response in membranous nephropathy; however, the optimal timing to evaluate antibody levels and how to combine them with other clinical variables are currently unknown.
Methods: We used a cohort of 85 patients from the Membranous Nephropathy Trial Of Rituximab (MENTOR) with anti-PLA2R antibodies ≥14 RU/ml to identify risk factors for not experiencing proteinuria remission after 12 months of treatment with cyclosporine or rituximab. Three landmark times were considered: at baseline and after 3 and 6 months of treatment.
Background: Despite MN being one of the most common causes of nephrotic syndrome worldwide, its biological and environmental determinants are poorly understood in large-part due to it being a rare disease. Making use of the UK Biobank, a unique resource holding a clinical dataset and stored DNA, serum and urine for ~500,000 participants, this study aims to address this gap in understanding.
Methods: The primary outcome was putative MN as defined by ICD-10 codes occurring in the UK Biobank.
Article Synopsis
- Membranous nephropathy (MN) is the main cause of nephrotic syndrome in adults, distinguished by autoantibodies against specific glomerular antigens like PLA2R1 and THSD7A.
- Researchers genotyped 1,409 MN patients to compare genetic risk factors associated with different autoantibody statuses against a control group.
- The findings show that patients with anti-PLA2R1 antibodies have a higher genetic risk score (GRS) compared to controls and those with anti-THSD7A antibodies, indicating distinct genetic influences and suggesting some antibody-negative MN cases might still be linked to autoimmunity against PLA2R1.
Background: Since the emergence of the anti-PLA2R antibody (PLA2R-Ab) test, nephrology practice has not changed dramatically, with most nephrologists still relying on a kidney biopsy to diagnose membranous nephropathy. In this study, we examined the clinical accuracy of the anti-PLA2R antibody test using ELISA in routine clinical care.
Methods: We conducted a retrospective analysis of PLA2R-Ab testing in 187 consecutive patients seen at a single UK centre between 2003 and 2020.