Distinguish primary from secondary membranous nephropathy.

The leading cause of
nephrotic syndrome.

Membranous nephropathy (MN) is one of the leading causes of nephrotic syndrome in adults.2 Most cases of MN are autoimmune in nature and referred to as primary membranous nephropathy, while the remainder of cases are associated with other diseases or exposures and referred to as secondary membranous nephropathy. The natural course of MN is variable and unpredictable, resulting in ongoing challenges for disease management.

Improve patient outcomes.

Until recently, researchers and clinicians described primary MN as idiopathic membranous nephropathy. The discovery of antibodies against intrinsic podocyte antigens (PLA2R) and thrombospondin-like domain 7A (THSD7A) established that MN is a kidney-specific autoimmune disease.3 Further classification of disease subtypes is critical for accurate diagnosis and intervention.4


of primary MN patients are positive for anti-THSD7A.

Your partner for accuracy.

Distinguishing primary MN from secondary MN requires extensive clinical, laboratory, and pathologic evaluation to accurately identify the underlying etiology. To increase accuracy and improve patient outcomes, serology testing for MN is performed by two assays in the same laboratory. Comprehensive renal testing services, concise results, and access to more than 150 years of advanced medical knowledge deliver the answers your practice needs to keep care local.

A test in focus

John Lieske, M.D., gives an overview of the phospholipase A2 receptor antibodies testing available through Mayo Clinic Laboratories. He discusses when this testing should be ordered, how this testing improves upon previous testing approaches, and what clinical action can be taken due to the results of this testing.

Identify the antigen

PLA2R | Phospholipase A2 Receptor Antibodies, Serum

Anti-phospholipase A2 receptor (PLA2R) antibodies are higly specific for the diagnosis of primary membranous nephropathy. A titer increase, decrease, or disappearance generally procedes a change in clinical status.

When to order testing?

  • Confirm disease subtype when a patient presents with suspected nephrotic syndrome.
  • Initiate immunosuppressive therapy in patients with primary MN.
  • Monitor immunosuppressive treatment responses.
  • Determine relapse recurrence in chronic kidney disease patients awaiting a transplant.


of primary MN patients are positive for anti-PLA2R.

Confirm the cause

THSD7 | Thrombospondin Type-1 Domain-Containing 7A Antibodies, Serum

When to order testing?

  • Confirm disease subtype when a patient presents with nephrotic syndrome and is PLA2R-negative.
  • Monitor immunosuppressive treatment response.
  • Determine if cancer screening is appropriate


of negative anti-PLA2R patients will be positive anti-THSD7A.

Learn more about how to order this evaluation at your institution.

Additional resources

Patient Resources