Serum Phospholipase A2 Receptor Antibody Is Associated with Thrombogenesis in Primary Membranous Nephropathy: A Systematic Review and Meta-Analysis
Published on March 19, 2026
Abstract
Introduction: Primary membranous nephropathy (PMN) is a leading cause of nephrotic syndrome in adults and is associated with an increased risk of thromboembolic events. The anti-serum phospholipase A2 receptor antibody (anti-PLA2R Ab) is highly specific for PMN, correlates with immunological disease activity, and evidence suggests that it may contribute to a prothrombotic state. This systematic review and meta-analysis aimed to further explore the potential association between serum anti-PLA2R Ab and thromboembolic events in patients with PMN and investigate whether they may serve as a possible biomarker for thrombogenesis. Methods: PubMed, Embase, and Cochrane databases were systematically searched for studies that investigated the presence of anti-PLA2R Ab as a potential risk factor for thrombogenesis in patients with PMN. Odds ratios (ORs) and mean differences with 95% confidence intervals (CIs) were pooled across studies. Heterogeneity was evaluated using I2 statistics. Results: We included seven studies involving 1,162 patients; mean age was 53 years. Patients with anti-PLA2R Ab had significantly higher odds of thromboembolism compared to those without anti-PLA2R Ab (OR 1.52; 95% CI 1.10, 2.09; p = 0.01). Patients diagnosed with thromboembolism exhibited significantly lower serum albumin levels compared to those without thromboembolism (p = 0.003), but there were no statistical differences in proteinuria (p = 0.18) or age (p = 0.90) between patients with and without thromboembolism. Proteinuria (p = 0.59), serum creatinine (p = 0.77), or estimated glomerular filtration rate (p = 0.59) did not differ between anti-PLA2R Ab-positive and negative patients. However, total cholesterol levels were higher in patients with positive anti-PLA2R Ab (p < 0.0001). Conclusion: There was a significant association between the presence of anti-PLA2R Ab and the risk of thromboembolism in patients with PMN, supporting their potential use as a biomarker for thrombogenesis in this population.