Poor renal outcomes in patients with anti-PLA2R antibodies may also be associated with epitope spreading of anti-PLA2R autoimmune response with less frequent nephrotic syndrome at presentation, a higher rate of spontaneous remission, and lower risk of progression to renal failure in patients with anti-PLA2R antibodies restricted to cysteine-rich domain of the PLA2R, compared with patients with concomitant positivity of antibodies to C-type lectin domain 1 and C-type lectin domain 7 (47). This evidence concerns the gene PLA2R1 and kidney failure.