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Membranous nephropathy 

Membranous nephropathy

Membranous nephropathy

Dwomoa Adu


May 25, 2011: This chapter has been re-evaluated and remains up-to-date. No changes have been necessary.

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date: 28 April 2017

Membranous nephropathy, which accounts for 20 to 30% of cases of the nephrotic syndrome in adults, is defined histologically by the presence of subepithelial immune deposits on the outer surface of the glomerular basement membrane. The immune mechanisms that lead to this are uncertain, and most cases are of unknown cause (idiopathic), but the condition can be associated with autoimmune diseases (systemic lupus erythematosus), malignancy (in 10% of cases, most commonly lung and prostate cancer), drugs, and infections.

Management and prognosis—untreated membranous nephropathy evolves either to remission or to the development of chronic renal failure. Treatment is contentious, but: (1) steroids alone are of no benefit in inducing remission or preventing endstage renal failure; (2) cyclophosphamide or chlorambucil together with prednisolone lead to more complete and partial remissions than prednisolone alone, but have no beneficial effect in preventing endstage renal failure; (3) ciclosporin probably has similar effects to cyclophosphamide/chlorambucil with prednisolone.

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