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CC BY-NC-ND 4.0 · Avicenna J Med 2012; 02(03): 60-64
DOI: 10.4103/2231-0770.102278
REVIEW ARTICLE

Membranous nephropathy: Treatment outline and risk stratification

Ziad Arabi
Department of Nephrology, University of Buffalo, NY, USA
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Abstract

Membranous nephropathy (MN) is the most common cause of nephrotic syndrome in adult. However, the exact etiology and the best treatment approach are still unclear. It is imperative to understand the nature of and prognosis of MN before initiating treatment which may include disease specific therapy based on a careful risk-stratification approach.

Keywords

Membranous - nephropathy - proteinuria - cyclophosphamide - ponticelli - ACE inhibitors


Publication History

Article published online:
09 August 2021

© 2012. Syrian American Medical Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Couser W, Shankland S. Membranous glomerulonephritis, comprehensive Clinical Nephrology. In: Feehally J, Floege J, editors. Buffalo, NY, USA: University of Buffalo; 2007. p. 295-309.
  • 2 Johnson R, Tisher C. Glomerular disease. In: Wilcox C, Tisher C, editors. Handbook of Nephrology and Hypertension. 2009. Univeristy of Baffalo, Department of Nephrology, Buffalo, NY, USA. p. 49-62.
  • 3 Beck LH Jr, Bonegio RG, Lambeau G, Beck DM, Powell DW, Cummins TD, et al. M-Type Phospholipase A 2 Receptor as Target Antigen in Idiopathic Membranous Nephropathy. N Engl J Med 2009;361:11-21.
  • 4 Segal PE, Choi MJ.Recent advances and prognosis in idiopathic membranous nephropathy.Adv Chronic Kidney Dis 2012;19:114-9.
  • 5 Herrmann SM, Sethi S, Fervenza FC. Membranous nephropathy: The start of a paradigm shift. Curr Opin Nephrol Hypertens 2012;21:203-10.
  • 6 Polanco N, Gutiérrez E, Covarsí A, Ariza F, Carreño A, Vigil A, et al. Spontaneous remission of nephrotic syndrome in idiopathic membranous nephropathy. J Am Soc Nephrol 2010;21:697-704.
  • 7 Troyanov S, Wall CA, Miller JA, Scholey JW, Cattran DC, Toronto GlomerulonephritisRegistry Group. Idiopathic membranous nephropathy: Definition and relevance of a partial remission. Kidney Int 2004;66:1199-205.
  • 8 du Buf-Vereijken PW, Branten AJ, Wetzels JF. Idiopathic membranous nephropathy: Outline and rationale of a treatment strategy. Am J Kidney Dis 2005;46:1012-29.
  • 9 Cattran DC, Reich HN, Beanlands HJ, Miller JA, Scholey JW, Troyanov S, et al. The impact of sex in primary glomerulonephritis.Nephrol Dial Transplant 2008;23:2247-53.
  • 10 Wheeler DC, Bernard DB. Lipid abnormalities in the nephrotic syndrome: Causes, consequences, and treatment. Am J Kidney Dis 1994;23:331-46.
  • 11 Massy ZA, Ma JZ, Louis TA, Kasiske BL.Lipid-lowering therapy in patients with renal disease. Kidney Int 1995;48:188-98.
  • 12 Rabelink AJ,Hené RJ, Erkelens DW, Joles JA, Koomans HA. The effects of simvastatin and cholestyramine on lipoprotein profile in hyperlipidemia of nephrotic syndrome. Lancet 1988;2:133.
  • 13 Burton C, Harris KP.The role of proteinuria in the progression of chronic renal failure.Am J Kidney Dis 1996;27:765-75.
  • 14 Cattran DC,Delmore T, Roscoe J, Cole E, Cardella C, Charron R, et al. A randomized controlled trial of prednisone in patients with idiopathic membranous nephropathy. N Engl J Med 1989;320:210-5.
  • 15 Cameron JS, Healy MJ, Adu D.The Medical Research Council trial of short-term high-dose alternate day prednisolone in idiopathic membranous nephropathy with nephrotic syndrome in adults.The MRC Glomerulonephritis Working Party. Q J Med 1990;74:133-56.
  • 16 Ponticelli C, Zucchelli P, Passerini P, Cesana B, Locatelli F, Pasquali S, et al. A 10-year follow-up of a randomized study with methylprednisolone and chlorambucil in membranous nephropathy. Kidney Int 1995;48:1600-4.
  • 17 Ponticelli C, Altieri P, Scolari F, Passerini P, Roccatello D, Cesana B, et al. A randomized study comparing methylprednisolone plus chlorambucil versus methylprednisolone plus cyclophosphamide in idiopathic membranous nephropathy. J Am Soc Nephrol 1998;9:444-50.
  • 18 Passerini P, Ponticelli C. Corticosteroids, cyclophosphamide, and chlorambucil therapy of membranous nephropathy. SeminNephrol 2003;23:355-61.
  • 19 Cattran DC, Appel GB,Hebert LA, Hunsicker LG, Pohl MA, Hoy WE, et al. Cyclosporine in patients with steroid-resistant membranous nephropathy: A randomized trial. Kidney Int 2001;59:1484-9.
  • 20 Fritsche L, BuddeK,Färber L, Charissé G, Kunz R, Gaedeke J, et al. Treatment of membranous glomerulopathy with cyclosporine A: How much patience is required? Nephrol Dial Transplant 1999:14:1036-8.
  • 21 Praga M, Barrio V, Juárez GF, Luño J, GrupoEspañol de Estudio de la NefropatíaMembranosa. Tacrolimusmonotherapy in membranous nephropathy: A randomized controlled trial. Kidney Int 2007;71:924-30.
  • 22 Chen M, Li H, Li XY, Lu FM, Ni ZH,Xu FF, et al. Tacrolimus combined with corticosteroids in treatment of nephrotic idiopathic membranous nephropathy: A multicenter randomized controlled trial. Am J Med Sci 2010;339:233-8.
  • 23 Chan TM, Lin AW, Tang SC, Qian JQ, Lam MF, Ho YW. Prospective controlled study on mycophenolatemofetil and prednisolone in the treatment of membranous nephropathy with nephrotic syndrome. Nephrology(Carlton) 2007;12:576-81.
  • 24 Remuzzi G, Chiurchiu C, Abbate M, Brusegan V, Bontempelli M, Ruggenenti P. Rituximab for idiopathic membranous nephropathy. Lancet 2002;360:923-4.
  • 25 Bomback AS, Radhakrishnan J. Treatment of nephrotic syndrome with adrenocorticotropic hormone (ACTH). Discov Med 2011;12:91-6.
  • 26 Fervenza FC, Sethi S, Specks U. Idiopathic membranous nephropathy: Diagnosis and treatment. Clin J Am SocNephrol 2008;3:905-19.
  • 27 Cattran D. Management of membranous nephropathy: When and what for treatment. J Am SocNephrol 2005;16:1188-94.