#Kidney Disease ##膜性肾病 #
Nephritis is a common disease in nephrology, generally manifested as proteinuria, hematuria, hypertension, edema, etc., in general, if for an adult nephritis patient, because if no puncture is done, it is not clear which kidney pathology type, treatment can only be empiric medication treatment, there may be detours, delay the treatment of patients. But then again, renal puncture is an invasive test with risks of bleeding, infection, etc., and some patients cannot do puncture or have contraindications to renal puncture for special reasons.
With the advancement of medicine, more and more non-invasive tests are applied to the diagnosis of kidney disease, phospholipase A2 receptor antibody (PLA2R antibody) is a signature antibody of idiopathic membranous nephropathy, if the antibody is positive, often prompting the patient to be membranous nephropathy, in this case, if the patient is unwilling to puncture or the risk of puncture is high, you can first treat according to idiopathic membrane nephropathy, and dynamically monitor the PLA2R antibody titer during treatment can also judge the patient's treatment effect. If the PLA2R antibody titer gradually decreases, suggesting that the patient can be treated with the drug and that the disease is in remission.
Although PLA2R antibody has important significance in the diagnosis of membranous nephropathy, but a negative PLA2R antibody does not exclude the possibility of membranous nephropathy, nor can it distinguish between patients who are currently in several stages of membranous nephropathy (membranous nephropathy can be divided into four stages under pathology), so PLA2R antibodies have some limitations, if the patient has no obvious contraindications to renal puncture, it is recommended to perform renal puncture, because renal puncture is the gold standard for the diagnosis of nephritis patients, which can not only clarify the pathological type and stage, It is also possible to judge the prognosis of the patient.