Home > Journals > Minerva Medica > Past Issues > Minerva Medica 2012 August;103(4) > Minerva Medica 2012 August;103(4):253-66

CURRENT ISSUE
 

JOURNAL TOOLS

eTOC
To subscribe
Submit an article
Recommend to your librarian
 

ARTICLE TOOLS

Reprints
Permissions

 

  TARGETING: RENAL DISEASES 

Minerva Medica 2012 August;103(4):253-66

Copyright © 2012 EDIZIONI MINERVA MEDICA

language: English

An overview of immunosuppressive therapy in idiopathic membranous nephropathy

Maas R. J., Hofstra J. M., Wetzels J. F.

Department of Nephrology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands


PDF


Idiopathic membranous nephropathy is the most common cause of nephrotic syndrome. In patients who present with nephrotic range proteinuria the clinical course is variable, with 50% of patients developing end stage renal disease after extended follow-up without therapy. We review the various immunosuppressive treatment modalities. The efficacy of alkylating agents is demonstrated in randomized trials, although side effects are a major drawback. Calcineurin inhibitors, rituximab and possibly adrenocorticotropic hormone (ACTH) are able to induce remission of proteinuria, which portends a good prognosis. However, the efficacy of these agents must be confirmed in randomized trials with adequate renal end points. Immunosuppressive treatment should be restricted to high risk patients. The use of immunosuppressive therapy has improved outcome of patients with iMN, with nowadays less than 10% of patients progressing to end stage renal disease (ESRD).

top of page