Reimagining the kidney biopsy in the era of diagnostic biomarkers of glomerular disease.

ABSTRACT

Anti-phospholipase A2 receptor (PLA2R) antibody is a specific biomarker for primary membranous nephropathy (MN). Testing positive for anti-PLA2R has been postulated to establish a diagnosis of MN in the absence of a kidney biopsy. Bobart et al. tested this hypothesis and concluded that anti-PLA2R positivity is sufficient to diagnose primary MN and initiate treatment in a subset of patients with nephropathy. This biomarker, however, does not render the kidney biopsy obsolete, but encourages the application of molecular analyses to renal pathology to keep the biopsy relevant.