Economic Benefit of Anti-PLA2R Antibody Testing in the Diagnosis of Membranous Nephropathy: A Single-Center Cost Analysis

Background: This study aimed to evaluate the financial impact of using anti-phospholipase A2 receptor antibody testing instead of kidney biopsy for diagnosing membranous nephropathy.

Methods: A retrospective cross-sectional study was conducted at Gazi University Faculty of Medicine Hospital between
November 2022 and January 2024. Seventy adult patients with nephrotic syndrome underwent anti-phospholipase
A2 receptor antibody testing using an enzyme-linked immunosorbent assay. The costs of diagnosis based on serology and kidney biopsy were compared.

Results: Among 70 patients, 18 tested positive for anti-phospholipase A2 receptor antibodies. Of these, 13 were diagnosed without a kidney biopsy, leading to a cost reduction of approximately 52 000 Turkish Liras (1300 American Dollars). The total expense for anti-phospholipase A2 receptor antibody testing was significantly lower than that of kidney biopsy, which required hospitalization and procedural costs. If all antibody-positive patients had been diagnosed without a biopsy, the potential savings would have reached 24 000 Turkish Liras (600 American Dollars).

Conclusion: Anti-phospholipase A2 receptor antibody testing provides a cost-effective, non-invasive alternative to kidney biopsy for diagnosing membranous nephropathy. Implementing a serology-first approach in selected cases may signifi cantly reduce healthcare expenditures while maintaining diagnostic accuracy.

Cite this article as: Demirezen A, Malkoç NA, Akçay ÖF, et al. Economic benefit of anti-PLA2R antibody testing in the diagnosis of membranous nephropathy: A single-center cost analysis. Turk J Nephrol. 2025;34(4):267-271.