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Anti-PLA2R antibody levels are associated with thromboembolism risk in individuals with membranous nephropathy and hypoalbuminemia.

Created on 14 Aug 2026

Authors

Ayman Al Jurdi, Christopher El Mouhayyar, Karim Yatim, Orhan Efe, Saif A Muhsin, Leonardo V Riella, Reza Zonozi, Karen Laliberte, John L Niles, Anushya Jeyabalan

Published in

Journal of nephrology. Aug 14, 2026. Epub Aug 14, 2026.

Abstract

Studies to evaluate markers of thrombotic risk in individuals with high-risk membranous nephropathy (MN) are needed. We hypothesized that high anti-phospholipase A2 receptor (PLA2R) titers at the time of severe hypoalbuminemia, reflecting ongoing immunologic disease activity, may be associated with a higher risk of thrombotic complications.
We conducted a multicenter retrospective cohort study of individuals with membranous nephropathy and serum albumin <2.5 g/dL and evaluated risk factors for first thrombotic events.
Sixty-seven individuals met the inclusion criteria. Median serum creatinine was 1.2 mg/dL (Interquartile range [IQR] 0.9-1.6), median urine protein-to-creatinine ratio (UPCR) was 11.9 g/g (IQR 8.5-16.5), and median nadir serum albumin level was 1.9 g/dL (IQR 1.6-2.2). Twenty-four individuals (36%) received no thromboprophylaxis, 20 (30%) received prophylaxis with only antiplatelets, and 23 (34%) received anticoagulation prophylaxis. Thrombotic events occurred in 11 individuals (16%) with incidence rates of 0.11, 0.10, and 0.02 per person-year in the no prophylaxis, antiplatelet, and anticoagulation groups, respectively. In individuals with anti-PLA2R antibody-positive MN who did not receive anticoagulation thromboprophylaxis, higher anti-PLA2R antibody levels were associated with a higher risk of developing thrombotic complications (adjusted Hazard Ratio [HR] = 1.51 per 10 RU/mL increase in PLA2R, 95% Confidence Interval [CI]: 1.10-2.09, P = .012) after adjusting for serum albumin nadir and age.
Higher anti-PLA2R antibody levels at the time of hypoalbuminemia are associated with a higher risk of thrombotic complications in individuals with anti-PLA2R-positive MN.

PMID:
42598914
Bibliographic data and abstract were imported from PubMed on 14 Aug 2026.

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