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Preference for anti-phospholipase A2 receptor antibody assay in patients with suspected membranous nephropathy: a survey study on medical practice after publication of Japanese Guidelines for Nephrotic Syndrome 2020

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Abstract

Background

International practice guidelines advocate for the use of anti-phospholipase A2 receptor (PLA2R) antibody testing to diagnose primary membranous nephropathy (pMN). This study aimed to clarify the current status of anti-PLA2R antibody testing in the diagnosis of pMN in Japan and to scrutinize the factors associated with the implementation of this antibody test.

Methods

Utilizing a web-based questionnaire for nephrologists, responses were collected from 306 facilities and 427 nephrologists between November 2021 and December 2021. Preference for anti-PLA2R antibody testing was also investigated. Factors related to the experience of quantifying anti-PLA2R antibodies were estimated by generalized estimating equations using a robust analysis of variance with clusters of facilities of affiliation.

Results

Of the 427 respondents, 140 (32.8%) had previous measurement experience at their current workplace and 165 (38.6%) had previous measurement experience overall. In pMN-suspected cases without contraindications to renal biopsy, 147 (34.4%) of the respondents opted to request anti-PLA2R antibody testing. The respondents’ experience with anti-PLA2R antibody quantification at their current place of work was generally higher in university hospitals and increased with the annual number of kidney biopsies and the number of years since graduation.

Conclusion

The results of this study suggest that a significant proportion of nephrologists in Japan have no experience in performing anti-PLA2R antibody assays, and that the assays may be hampered by the limited capabilities of the current workplace and the financial burden on facilities and patients.

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Data availability

The data underlying this article will be shared upon reasonable request from the corresponding authors.

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Acknowledgements

This study was supported in part by the Grants-in-Aid for Intractable Renal Diseases Research, Research on Rare and Intractable Diseases, and Health and Labor Sciences Research Grants from the Ministry of Health, Labor, and Welfare of Japan (ID 20FC1045). This funder had no role in the design, conduct, or reporting of the study.The authors would like to thank Editage (www.editage.jp) for English language editing.

Author information

Author notes

  1. Noriaki Kurita and Takehiko Wada share co-last authorship.

Authors and Affiliations

  1. Section of Education for Clinical Research, Kyoto University Hospital, Kyoto, Japan

    Sho Sasaki

  2. Center for Innovative Research for Communities and Clinical Excellence, Fukushima Medical University, Fukushima, Japan

    Sho Sasaki

  3. Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Sayaka Shimizu

  4. Patient Driven Academic League (PeDAL), Tokyo, Japan

    Sayaka Shimizu

  5. Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, Fukushima, Japan

    Sayaka Shimizu, Hiroki Nishiwaki & Noriaki Kurita

  6. Department of Nephrology and Rheumatology, Iwate Prefectural Central Hospital, Iwate, Japan

    Izaya Nakaya

  7. Department of Nephrology, Tokyo Medical University, Tokyo, Japan

    Yoshitaka Miyaoka

  8. Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine, Kanagawa, Japan

    Masahiro Koizumi & Takehiko Wada

  9. Division of Nephrology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Kanagawa, Japan

    Hiroki Nishiwaki

  10. Showa University Research Administration Center (SURAC), Showa University, Tokyo, Japan

    Hiroki Nishiwaki

  11. Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University, Kagawa, Japan

    Tadashi Sofue

  12. Department of Nephrology and Rheumatology, Aichi Medical University, Aichi, Japan

    Takuji Ishimoto

  13. Department of Innovative Research and Education for Clinicians and Trainees (DiRECT), Fukushima Medical University Hospital, Fukushima, Japan

    Noriaki Kurita

  14. Department of Nephrology, Toranomon Hospital, Tokyo, Japan

    Takehiko Wada

Authors
  1. Sho Sasaki
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  2. Sayaka Shimizu
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  3. Izaya Nakaya
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  4. Yoshitaka Miyaoka
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  5. Masahiro Koizumi
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  6. Hiroki Nishiwaki
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  7. Tadashi Sofue
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  8. Takuji Ishimoto
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  9. Noriaki Kurita
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  10. Takehiko Wada
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Contributions

Study concept and design: S Sasaki, S Shimizu, TW, and NK. Data collection: TW, S Shimizu, and NK. Data analysis: S Sasaki, S Shimizu, and NK. Data interpretation and manuscript preparation: S Sasaki, S Shimizu, IN, YM, MK, HN, TS, TI, NK, and TW.

Corresponding author

Correspondence to Sayaka Shimizu.

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Conflicts of interest

Honoraria: Noriaki Kurita (GlaxoSmithKline).

Ethical approval

This study was an anonymous survey of healthcare professionals to describe the practice of primary nephrotic syndrome and was considered outside the scope of the ethical review according to the Ethical Guidelines for Medical and Biological Research Involving Human Subjects [14]. The possibility of academic publication of the survey results was described at the beginning of the questionnaire and only those who provided consent to complete the survey were included.

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Sasaki, S., Shimizu, S., Nakaya, I. et al. Preference for anti-phospholipase A2 receptor antibody assay in patients with suspected membranous nephropathy: a survey study on medical practice after publication of Japanese Guidelines for Nephrotic Syndrome 2020. Clin Exp Nephrol (2024). https://doi.org/10.1007/s10157-024-02462-1

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  • DOI: https://doi.org/10.1007/s10157-024-02462-1

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