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Autoantibody formation directed against PLA2R1 is the underlying etiology in most cases of primary membranous glomerulopathy. This new understanding of the pathogenesis of primary membranous has rapidly transformed diagnosis and monitoring of this disease. Proteinuria can take months to resolve after a patient has undergone serologic remission and, as a result, is not an ideal biomarker of disease activity. Testing for levels of serum PLA2R autoantibodies gives a more accurate picture of the patient’s current disease status. Ideally, serum PLA2R testing would be performed immediately after biopsy diagnosis in cases with positive PLA2R staining on biopsy. At this point in...