Membranous nephropathy: an update

Abstract

Great advances have been made in the pathophysiologic and therapeutic areas of membranous nephropathy in the last years. The description of autoantibodies directed against phospholipase A2 receptor in the glomerulus has confirmed the autoimmune nature of the disease and has changed our diagnostic, classification, and treatment strategies. Rituximab has emerged as a great tool in the therapeutic armamentarium of membranous nephropathy, but a one-size-fits-all approach is far from being the rule. Nowadays, an individualized therapeutic scheme based on clinical and serologic data appears to be the most appropriate method to manage patients with membranous nephropathy. We present a review of the most important aspects published in the literature regarding membranous nephropathy, with an emphasis on the most novel topics with the intention of updating clinicians involved in the management of this disease.

Primary Membranous Nephropathy - what do we know today?

“…If an affected person has subnephrotic proteinuria and circulating anti-PLA2R antibodies they are more likely to develop nephrotic proteinuria along with worse renal function in later stages [25]. Microhematuria incidence is ranging from 40 to 60%, more often than macrohematuria, which suggests a different type of glomerulonephritis [26], [27]. Hypertension is found mostly in the latter stages of the disease, due to kidney failure [3].…”