Membranous nephropathy

• Membranous nephropathy involves deposits of immune complexes in the glomerular basement membrane

  • causes thickening and malfunctioning of the membrane and therefore proteinuria
• Histology shows IgG and complement deposits on the basement membrane
• Key cause of nephrotic syndrome in adults
• The majority (70%) are idiopathic
• Can be secondary to malignancy, SLE or drugs (NSAIDs)
• Antibodies directed against the phospholipase A2 receptor (PLA2R) that are highly expressed on podocytes are a major cause of primary MN seen in up to 80% of cases
• Traditionally, the diagnosis of MN requires histological analysis following renal biopsy. Patients should be tested for anti-PLA2R antibodies
• Patients with deteriorating kidney function may be treated with immunosuppressive therapy:

  • Rituximab
  • Cyclophosphamide