National cohort of all cases of membranous nephropathy (MN) during a 1 year period in France, based on a pathological and/or serological diagnostic, collecting the data on:
* incidence of MN * prevalence of anti-PLA2R1 and anti-THSD7A * clinical outcome one year after diagnosis or after relapse (complete remission, partial remission or persistent nephrotic syndrome) * environmental risk factors for the onset of MN * HLA markers * patient care status in France
Age 18 years or more
Biopsy on a native kidney consistent with MN and/or positivity for serum anti-PLA2R1 and/or anti-THSD7A antibodies
Signed informed consent
Diagnosis error based on the kidney biopsy staining or on serology analyses for the positivity for anti-PLA2R1 and/or anti-THSD7A
Patients unable to give an informed consent
Patients withdrawing an informed consent
Single group
Blood sample
Other interventionSerum samples will be sent for centralised analyses in Nice. On these samples, different analysis will be performed : * anti-PLA2R1 and anti-THSD7A antibodies * anti-PLA2R1 and anti-THSD7A epitopes * HLA typing
To determine the incidence of Membranous Nephropathy (MN) and its evolution
as either complete remission (UPCR \< 0.3 g/g, serum albumin \> 35 g/L, eGFR \> 60 ml/min/1.73 m²) or partial remission (UPCR \< 3.5 g/g and reduction of at least 50% from baseline, \< 20% increase of serum creatinin from baseline) or persistent nephrotic syndrome (UPCR \> 3.5 g/g, serum albumin \< 30 g/L)
Determination of incidence of primary and secondary forms of MN
Identification of environmental factors associated with the onset of MN
Thanks to a specific questionnaire data on medical history, lifestyle, demography and profession will be collected * Medical history: prior diagnosis of any autoimmune disease, cancer, infection or other, infection in the month before the diagnosis of MN, thrombosis, drugs taken at the moment of diagnosis, allergies and type of symptomes * Emotional state: emotional state at diagnosis, stressful or destabilizing event in the year preceding diagnosis of MN
Description of the standard of care for patients with MN in France
Treatment names and their duration (in weeks) will be collected
the prognostic value of epitope spreading in patients with PLA2R1-associated MN
Epitope spreading status is determined by measuring the positivity to anti-CysR, anti-CTLD1 and CTLD7 antibodies in the serum, by the means of ELISA and expressed as RU/mL. The patients with antibodies targetting CysR only are considered as non-spreaders, while the patients additionnaly targetting either CTLD1 and/or CTLD7 are considered as spreaders. Epitope spreading status (non-spreader or spreader) will be correlated to clinical outcome (complete remission, partial remission or persistent nephrotic syndrome, as defined under primary outcome measures) one year after inclusion.
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