{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T08:09:42Z","timestamp":1793261382719,"version":"4.5.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T00:00:00Z","timestamp":1749600000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T00:00:00Z","timestamp":1749600000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Nephrol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In recent years, there has been an emergence of new antigens discovered in membranous nephropathy (MN). Whether these antigens have impacted the approach to, and management of, MN patients undertaken by nephrologists is still unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cross-sectional international survey pertaining to 13 antigens recently discovered in MN. The survey was distributed by the National Kidney Foundation, direct emails, and social media.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>PLA2R, THSD7A, NELL1, and EXT1\/2 testing were readily available while the most common response for other antigen testing was \u2018Not Performed\u2019 or \u2018Unknown\u2019.\u00a0All respondents had tested for or treated PLA2R-positive\u00a0MN. Of 79 respondents, only 12.7% had treated THSD7A, 15.2% for NELL1 and 6.3% for EXT1\/2 positive MN. For PLA2R, THSD7A, and NELL1, a majority chose rituximab (75.4, 87.5, and 80.0%, respectively) as initial treatment, and would treat with immunosuppression before completing 6\u00a0months of conservative therapy. A majority of respondents would routinely or occasionally omit a kidney biopsy in the setting of positive serum anti-PLA2R antibodies, however, 27.5% would rarely do so. There was no clear consensus across respondents regarding the use of anti-PLA2R serum levels in determining remission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although many new MN antigens have been discovered, there is limited availability of tests identifying these less common\u00a0antigens. While the survey suggests potential for utilization of an antigen-tailored approach based on identified differences in screening and treatment practices, there remains a lag in the full adoption of this new information. Further progress in accessibility of antigen testing and research into antigen associations will enable a more individualized approach to the management of MN.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s40620-025-02313-6","type":"journal-article","created":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T13:54:09Z","timestamp":1749650049000},"page":"1889-1900","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical uptake of an antigen-based approach to membranous nephropathy: a survey of general nephrologists and glomerular disease experts"],"prefix":"10.1093","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7952-7726","authenticated-orcid":false,"given":"Eibhlin","family":"Goggins","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"DeLaat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryce","family":"Barr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Taliercio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Mehdi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georges","family":"Nakhoul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brendan","family":"Bowman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corey","family":"Cavanaugh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,6,11]]},"reference":[{"key":"2313_CR1","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1056\/NEJMoa0810457","volume":"361","author":"LH Beck Jr","year":"2009","unstructured":"Beck LH Jr, Bonegio RG, Lambeau G, Beck DM, Powell DW, Cummins TD, Klein JB, Salant DJ (2009) M-type phospholipase A2 receptor as target antigen in idiopathic membranous nephropathy. N Engl J Med 361:11\u201321","journal-title":"N Engl J Med"},{"key":"2313_CR2","doi-asserted-by":"crossref","unstructured":"Sethi S, Beck Jr LH, Glassock RJ, Haas M, De Vriese AS, Caza TN, Hoxha E, Lambeau G, Tomas NM, Madden B (2023) Mayo Clinic consensus report on membranous nephropathy: proposal for a novel classification. In: Mayo clinic proceedings. Elsevier, Amsterdam, pp 1671\u20131684","DOI":"10.1016\/j.mayocp.2023.08.006"},{"key":"2313_CR3","doi-asserted-by":"publisher","first-page":"2277","DOI":"10.1056\/NEJMoa1409354","volume":"371","author":"NM Tomas","year":"2014","unstructured":"Tomas NM, Beck LH Jr, Meyer-Schwesinger C, Seitz-Polski B, Ma H, Zahner G, Dolla G, Hoxha E, Helmchen U, Dabert-Gay A-S (2014) Thrombospondin type-1 domain-containing 7A in idiopathic membranous nephropathy. N Engl J Med 371:2277\u20132287","journal-title":"N Engl J Med"},{"key":"2313_CR4","doi-asserted-by":"publisher","first-page":"1286","DOI":"10.2215\/CJN.07210810","volume":"6","author":"JM Hofstra","year":"2011","unstructured":"Hofstra JM, Beck LH Jr, Beck DM, Wetzels JF, Salant DJ (2011) Anti-phospholipase A2 receptor antibodies correlate with clinical status in idiopathic membranous nephropathy. Clin J Am Soc Nephrol 6:1286\u20131291","journal-title":"Clin J Am Soc Nephrol"},{"key":"2313_CR5","doi-asserted-by":"publisher","first-page":"1735","DOI":"10.1681\/ASN.2012030242","volume":"23","author":"JM Hofstra","year":"2012","unstructured":"Hofstra JM, Debiec H, Short CD, Pell\u00e9 T, Kleta R, Mathieson PW, Ronco P, Brenchley PE, Wetzels JF (2012) Antiphospholipase A2 receptor antibody titer and subclass in idiopathic membranous nephropathy. J Am Soc Nephrol 23:1735\u20131743","journal-title":"J Am Soc Nephrol"},{"key":"2313_CR6","doi-asserted-by":"publisher","first-page":"826","DOI":"10.1093\/ndt\/gfab356","volume":"38","author":"P Ronco","year":"2023","unstructured":"Ronco P, Plaisier E, Debiec H (2023) The role of PLA2R antibody monitoring: what we know and what we do not know. Nephrol Dial Transplant 38:826\u2013833","journal-title":"Nephrol Dial Transplant"},{"key":"2313_CR7","doi-asserted-by":"publisher","first-page":"940","DOI":"10.1038\/ki.2012.486","volume":"83","author":"D Kanigicherla","year":"2013","unstructured":"Kanigicherla D, Gummadova J, McKenzie EA, Roberts SA, Harris S, Nikam M, Poulton K, McWilliam L, Short CD, Venning M (2013) Anti-PLA2R antibodies measured by ELISA predict long-term outcome in a prevalent population of patients with idiopathic membranous nephropathy. Kidney Int 83:940\u2013948","journal-title":"Kidney Int"},{"key":"2313_CR8","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0281726","volume":"18","author":"O Ragy","year":"2023","unstructured":"Ragy O, Rautemaa V, Smith A, Brenchley P, Kanigicherla D, Hamilton P (2023) Can use of the serum anti-PLA2R antibody negate the need for a renal biopsy in primary membranous nephropathy? PLoS\u00a0One 18:e0281726","journal-title":"PLoS\u00a0One"},{"key":"2313_CR9","doi-asserted-by":"publisher","first-page":"1833","DOI":"10.2215\/CJN.05480421","volume":"16","author":"SA Bobart","year":"2021","unstructured":"Bobart SA, Han H, Tehranian S, De Vriese AS, Roman JCL, Sethi S, Zand L, Gomez CA, Giesen CD, Soler MJ (2021) Noninvasive diagnosis of PLA2R-associated membranous nephropathy: a validation study. Clin J Am Soc Nephrol 16:1833\u20131839","journal-title":"Clin J Am Soc Nephrol"},{"key":"2313_CR10","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1016\/j.kint.2021.05.021","volume":"100","author":"B Rovin","year":"2021","unstructured":"Rovin B, Adler S, Barratt J, Bridoux F, Burdge K, Chan T, Cook H, Fervenza F, Gibson K, Glassock R (2021) Kidney disease: improving global outcomes (KDIGO) glomerular diseases work group. KDIGO 2021 clinical practice guideline for the management of glomerular diseases. Kidney Int 100:S1\u2013S276","journal-title":"Kidney Int"},{"key":"2313_CR11","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1186\/s12879-022-07092-0","volume":"22","author":"Z-N Liao","year":"2022","unstructured":"Liao Z-N, Tao L-J, Yin H-l, Xiao X-C, Lei M-X, Peng Z-Z (2022) Schistosoma japonicum infection associated with membranous nephropathy: a case report. BMC Infect Dis 22:125","journal-title":"BMC Infect Dis"},{"key":"2313_CR12","doi-asserted-by":"publisher","first-page":"385","DOI":"10.25259\/ijn_363_23","volume":"34","author":"R Badge","year":"2024","unstructured":"Badge R, Rathore V, Aggarwal J (2024) Filariasis-associated secondary membranous nephropathy: a rare presentation. Indian J Nephrol 34:385","journal-title":"Indian J Nephrol"},{"key":"2313_CR13","doi-asserted-by":"publisher","first-page":"442","DOI":"10.1093\/ckj\/sfac237","volume":"16","author":"S Sethi","year":"2023","unstructured":"Sethi S (2023) The many faces of NELL1 MN. Clin Kidney J 16:442\u2013446","journal-title":"Clin Kidney J"},{"key":"2313_CR14","doi-asserted-by":"publisher","first-page":"1379","DOI":"10.1016\/j.ekir.2024.02.1401","volume":"9","author":"RS Avasare","year":"2024","unstructured":"Avasare RS, Clark S, Spain RI, Wusirika R, Rope R, Gurley S, Stanaway M, Sekulic M, Santoriello D, Bomback AS (2024) Characteristics and outcomes of NELL1 membranous nephropathy in lipoic acid users and nonusers. Kidney Int Rep 9:1379\u20131386","journal-title":"Kidney Int Rep"},{"key":"2313_CR15","doi-asserted-by":"publisher","first-page":"1683","DOI":"10.1016\/j.ekir.2023.05.023","volume":"8","author":"D Santoriello","year":"2023","unstructured":"Santoriello D, Ramaswamy R, Kudose S, Markowitz GS (2023) Segmental NELL-1 membranous nephropathy complicating tiopronin therapy. Kidney Int Rep 8:1683\u20131686","journal-title":"Kidney Int Rep"},{"key":"2313_CR16","doi-asserted-by":"publisher","first-page":"921","DOI":"10.1016\/j.ekir.2022.12.026","volume":"8","author":"R Miyazaki","year":"2023","unstructured":"Miyazaki R, Ueda H, Hayashi A, Okabe M, Katsuma A, Shimizu A, Joh K, Tsuboi N, Ikeda M, Miyazaki Y (2023) Neural epidermal growth factor-like 1\u2013positive membranous nephropathy with rheumatoid arthritis. Kidney Int Rep 8:921\u2013924","journal-title":"Kidney Int Rep"},{"key":"2313_CR17","doi-asserted-by":"publisher","first-page":"1424","DOI":"10.1016\/j.kint.2022.09.001","volume":"102","author":"AA Kurien","year":"2022","unstructured":"Kurien AA, Ks JP, Walker PD, Caza TN (2022) Traditional indigenous medicines are an etiologic consideration for NELL1-positive membranous nephropathy. Kidney Int 102:1424\u20131426","journal-title":"Kidney Int"},{"key":"2313_CR18","doi-asserted-by":"publisher","first-page":"1240","DOI":"10.1016\/j.kint.2021.08.014","volume":"100","author":"M Le Quintrec","year":"2021","unstructured":"Le Quintrec M, Teisseyre M, Bec N, Delmont E, Szwarc I, Perrochia H, Machet MC, Chauvin A, Mavroudakis N, Taieb G (2021) Contactin-1 is a novel target antigen in membranous nephropathy associated with chronic inflammatory demyelinating polyneuropathy. Kidney Int 100:1240\u20131249","journal-title":"Kidney Int"},{"key":"2313_CR19","doi-asserted-by":"publisher","first-page":"946","DOI":"10.1056\/NEJM198404123101503","volume":"310","author":"C Ponticelli","year":"1984","unstructured":"Ponticelli C, Zucchelli P, Imbasciati E, Cagnoli L, Pozzi C, Passerini P, Grassi C, Limido D, Pasquali S, Volpini T (1984) Controlled trial of methylprednisolone and chlorambucil in idiopathic membranous nephropathy. N Engl J Med 310:946\u2013950","journal-title":"N Engl J Med"},{"key":"2313_CR20","doi-asserted-by":"publisher","first-page":"1600","DOI":"10.1038\/ki.1995.453","volume":"48","author":"C Ponticelli","year":"1995","unstructured":"Ponticelli C, Zucchelli P, Passerini P, Cesana B, Locatelli F, Pasquali S, Sasdelli M, Redaelli B, Grassi C, Pozzi C (1995) A 10-year follow-up of a randomized study with methylprednisolone and chlorambucil in membranous nephropathy. Kidney Int 48:1600\u20131604","journal-title":"Kidney Int"},{"key":"2313_CR21","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1681\/ASN.V93444","volume":"9","author":"C Ponticelli","year":"1998","unstructured":"Ponticelli C, Altieri P, Scolari F, Passerini P, Roccatello D, Cesana B, Melis P, Valzorio B, Sasdelli M, Pasquali S (1998) A randomized study comparing methylprednisolone plus chlorambucil versus methylprednisolone plus cyclophosphamide in idiopathic membranous nephropathy. J Am Soc Nephrol 9:444\u2013450","journal-title":"J Am Soc Nephrol"},{"key":"2313_CR22","doi-asserted-by":"publisher","first-page":"923","DOI":"10.1016\/S0140-6736(02)11042-7","volume":"360","author":"G Remuzzi","year":"2002","unstructured":"Remuzzi G, Chiurchiu C, Abbate M, Brusegan V, Bontempelli M, Ruggenenti P (2002) Rituximab for idiopathic membranous nephropathy. Lancet 360:923\u2013924","journal-title":"Lancet"},{"key":"2313_CR23","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1056\/NEJMoa1814427","volume":"381","author":"FC Fervenza","year":"2019","unstructured":"Fervenza FC, Appel GB, Barbour SJ, Rovin BH, Lafayette RA, Aslam N, Jefferson JA, Gipson PE, Rizk DV, Sedor JR (2019) Rituximab or cyclosporine in the treatment of membranous nephropathy. N Engl J Med 381:36\u201346","journal-title":"N Engl J Med"},{"key":"2313_CR24","doi-asserted-by":"publisher","first-page":"972","DOI":"10.1681\/ASN.2020071091","volume":"32","author":"F Scolari","year":"2021","unstructured":"Scolari F, Delbarba E, Santoro D, Gesualdo L, Pani A, Dallera N, Mani L-Y, Santostefano M, Feriozzi S, Quaglia M (2021) Rituximab or cyclophosphamide in the treatment of membranous nephropathy: the RI-CYCLO randomized trial. J Am Soc Nephrol 32:972\u2013982","journal-title":"J Am Soc Nephrol"},{"key":"2313_CR25","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1111\/nep.13953","volume":"27","author":"B Bose","year":"2022","unstructured":"Bose B, Badve SV, Johnson DW, Hawley C, Jha V, Reidlinger D, Peh CA (2022) Treatment preferences for primary membranous nephropathy: results of a multinational survey among nephrologists in the South Asia Pacific region. Nephrology 27:35\u201343","journal-title":"Nephrology"},{"key":"2313_CR26","doi-asserted-by":"publisher","first-page":"767","DOI":"10.1007\/s10157-023-02366-6","volume":"27","author":"T Wada","year":"2023","unstructured":"Wada T, Shimizu S, Koizumi M, Sofue T, Nishiwaki H, Sasaki S, Nakaya I, Oe Y, Ishimoto T, Furuichi K (2023) Japanese clinical practice patterns of primary nephrotic syndrome 2021: a web-based questionnaire survey of certified nephrologists. Clin Exp Nephrol 27:767\u2013775","journal-title":"Clin Exp Nephrol"},{"key":"2313_CR27","doi-asserted-by":"publisher","first-page":"1725","DOI":"10.1016\/j.ekir.2019.09.005","volume":"4","author":"MM O\u2019Shaughnessy","year":"2019","unstructured":"O\u2019Shaughnessy MM, Troost JP, Bomback AS, Hladunewich MA, Ashoor IF, Gibson KL, Matar RB, Selewski DT, Srivastava T, Rheault MN (2019) Treatment patterns among adults and children with membranous nephropathy in the Cure Glomerulonephropathy Network (CureGN). Kidney Int Rep 4:1725\u20131734","journal-title":"Kidney Int Rep"},{"key":"2313_CR28","doi-asserted-by":"publisher","first-page":"1283","DOI":"10.2215\/CJN.0000000000000237","volume":"18","author":"SJ Barbour","year":"2023","unstructured":"Barbour SJ, Fervenza FC, Induruwage D, Brenchley PE, Rovin B, Hladunewich MA, Reich HN, Lafayette R, Aslam N, Appel GB (2023) Anti-PLA2R antibody levels and clinical risk factors for treatment nonresponse in membranous nephropathy. Clin J Am Soc Nephrol 18:1283\u20131293","journal-title":"Clin J Am Soc Nephrol"},{"key":"2313_CR29","doi-asserted-by":"publisher","first-page":"1123","DOI":"10.1681\/ASN.2018080852","volume":"30","author":"S Sethi","year":"2019","unstructured":"Sethi S, Madden BJ, Debiec H, Charlesworth MC, Gross L, Ravindran A, Hummel AM, Specks U, Fervenza FC, Ronco P (2019) Exostosin 1\/exostosin 2\u2013associated membranous nephropathy. J Am Soc Nephrol 30:1123\u20131136","journal-title":"J Am Soc Nephrol"},{"key":"2313_CR30","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1681\/ASN.2020081181","volume":"32","author":"A Ravindran","year":"2021","unstructured":"Ravindran A, Moura MC, Fervenza FC, Nasr SH, Alexander MP, Fidler ME, Hernandez LPH, Zhang P, Grande JP, Cornell LD (2021) In patients with membranous lupus nephritis, exostosin-positivity and exostosin-negativity represent two different phenotypes. J Am Soc Nephrol 32:695\u2013706","journal-title":"J Am Soc Nephrol"}],"container-title":["Journal of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40620-025-02313-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s40620-025-02313-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40620-025-02313-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T15:59:19Z","timestamp":1777564759000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/joneph\/article\/38\/7\/1889\/8457460"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,11]]},"references-count":30,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["2313"],"URL":"https:\/\/doi.org\/10.1007\/s40620-025-02313-6","relation":{},"ISSN":["1724-6059"],"issn-type":[{"value":"1724-6059","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,11]]},"assertion":[{"value":"7 January 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 April 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 June 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors report no conflicts of interest related to this research. The authors have no financial interests related to this research to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This research proposal was reviewed and approved by the University of Virginia Institutional Review Board for Health Sciences Research (tracking number: HSR 24758).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"This study was performed in accordance with the ethical standards of the Helsinki Declaration.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human and animal rights"}},{"value":"Participation in the survey was voluntary.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent to participate"}}]}}