Membranous Nephropathy: Review

Background: Membranous nephropathy (MN) is the most common cause of nephrotic syndrome (NS) in adults, accounting for about 20.0% of all NS cases. With an increasing prevalence, especially in the elderly, it has received great attention in Asia. Summary: Recently, the prevalence of idiopathic MN (IMN) has significantly increased among the elderly people in Asia and other places in the world. Although the exact mechanism of IMN remains unveiled, the identification of new antigens such as PLA2R and THSD7A has greatly enhanced our understanding of its pathogenesis. However, consensus has not yet been reached for the treatment of IMN in Asia. For example, there are many choices of immunosuppressive agents, including corticosteroid monotherapy, corticosteroids combined with cytotoxic agents [such as alkylating agents, calcineurin inhibitors or mycophenolate mofetil (MMF)] or traditional Chinese medicine (triptolide, Shenqi and other Chinese herbal soups). Patients with IMN in Asia often have a favorable prognosis, and progression to end-stage renal disease is relatively uncommon Received: April 16, 2015 Accepted: June 30, 2015 Published online: September 1, 2015 Nan Chen Department of Nephrology, Ruijin Hospital Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road Shanghai, 200025 (China) E-Mail cnrj100 @ 126.com © 2015 S. Karger AG, Basel 2296–9381/15/0012–0119$39.50/0 www.karger.com/kdd For the management of membranous nephropathy in Western countries, see Alfaadhel and Cattran, Kidney Dis 2015;1:126–137. D ow nl oa de d by : 54 .7 0. 40 .1 1 10 /6 /2 01 7 8: 54 :5 3 P M