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Journal of Nephrology

, Volume 31, Issue 4, pp 489–502 | Cite as

Treatment of primary membranous nephropathy: where are we now?

  • Andrea Angioi
  • Nicola Lepori
  • Ana Coloma López
  • Sanjeev Sethi
  • Fernando C. Fervenza
  • Antonello Pani
Review
  • 1k Downloads

Abstract

In the last 10 years, basic science and clinical research have made important contributions to the understanding and management of primary membranous nephropathy (MN). The identification of antibodies directed against the M-type phospholipase A2 receptor (PLA2R) and thrombospondin type-1 domain-containing 7A protein have added a new perspective on diagnosis, monitoring the immunological activity, predicting prognosis and guiding therapy in patients with primary MN. Mounting evidence suggests that quantification and follow-up of antiPLA2R Abs levels can help in assessing prognosis and evaluate the response to treatment. The kidney disease improving global outcomes guidelines published in 2012 have not been updated. New data on the use of rituximab suggest it should be considered as a potential initial therapy in the treatment of patients with primary MN.

Keywords

Membranous glomerulonephritis Immunosuppression Renal diseases Glomerulopathies 

Notes

Acknowledgements

The authors declare that they do not have any conflict of interest that positively or negatively influenced the article’s content.

Funding

We did not receive any funding to support this review.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

This research does not involve human subjects and human data, but only reports clinical trials and observational studies published in the literature in peer reviewed journals.

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Copyright information

© Italian Society of Nephrology 2017

Authors and Affiliations

  • Andrea Angioi
    • 1
  • Nicola Lepori
    • 1
  • Ana Coloma López
    • 2
  • Sanjeev Sethi
    • 3
  • Fernando C. Fervenza
    • 2
  • Antonello Pani
    • 1
  1. 1.Division of Nephrology and DialysisAzienda Ospedaliera G. BrotzuCagliariItaly
  2. 2.Division of Nephrology and HypertensionMayo ClinicRochesterUSA
  3. 3.Department of Anatomic PathologyMayo ClinicRochesterUSA

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