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Condition

Membranous Nephropathy

Symptoms, Doctors, Treatments, Research & More

Condition 101

What is the definition of Membranous Nephropathy?

Membranous nephropathy is a kidney disorder that leads to changes and inflammation of the structures inside the kidney that help filter wastes and fluids. The inflammation may lead to problems with kidney function.

What are the alternative names for Membranous Nephropathy?

Membranous glomerulonephritis; Membranous GN; Extramembranous glomerulonephritis; Glomerulonephritis - membranous; MGN

What are the causes for Membranous Nephropathy?

Membranous nephropathy is caused by the thickening of a part of the glomerular basement membrane. The glomerular basement membrane is a part of the kidneys that helps filter waste and extra fluid from the blood. The exact reason for this thickening is not known.

The thickened glomerular membrane does not work normally. As a result, large amounts of protein are lost in the urine.

This condition is one of the most common causes of nephrotic syndrome. This is a group of symptoms that include protein in the urine, low blood protein level, high cholesterol levels, high triglyceride levels, and swelling. Membranous nephropathy may be a primary kidney disease, or it may be associated with other conditions.

The following increase your risk for this condition:

  • Cancers, especially lung and colon cancer
  • Exposure to toxins, including gold and mercury
  • Infections, including hepatitis B, malaria, syphilis, and endocarditis
  • Medicines, including penicillamine, trimethadione, and skin-lightening creams
  • Systemic lupus erythematosus, rheumatoid arthritis, Graves disease, and other autoimmune disorders

The disorder occurs at any age, but is more common after age 40.

What are the symptoms for Membranous Nephropathy?

Symptoms often begin slowly over time, and may include:

  • Edema (swelling) in any area of the body
  • Fatigue
  • Foamy appearance of urine (due to large amounts of protein)
  • Poor appetite
  • Urination, excessive at night
  • Weight gain

What are the current treatments for Membranous Nephropathy?

The goal of treatment is to reduce symptoms and slow the progression of the disease.

Controlling blood pressure is the most important way to delay kidney damage. The goal is to keep blood pressure at or below 130/80 mm Hg.

High blood cholesterol and triglyceride levels should be treated to reduce the risk for atherosclerosis. However, a low-fat, low-cholesterol diet is often not as helpful for people with membranous nephropathy.

Medicines used to treat membranous nephropathy include:

  • Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) to lower blood pressure
  • Corticosteroids and other drugs that suppress the immune system
  • Medicines (most often statins) to reduce cholesterol and triglyceride levels
  • Water pills (diuretics) to reduce swelling
  • Blood thinners to reduce the risk for blood clots in the lungs and legs

Low-protein diets may be helpful. A moderate-protein diet (1 gram [gm] of protein per kilogram [kg] of body weight per day) may be suggested.

Vitamin D may need to be replaced if nephrotic syndrome is long-term (chronic) and does not respond to therapy.

This disease increases the risk for blood clots in the lungs and legs. Blood thinners may be prescribed to prevent these complications.

What is the outlook (prognosis) for Membranous Nephropathy?

The outlook varies, depending on the amount of protein loss. There may be symptom-free periods and occasional flare-ups. Sometimes, the condition goes away, with or without therapy.

Most people with this disease will have kidney damage and some people will develop end-stage renal disease.

What are the possible complications for Membranous Nephropathy?

Complications that may result from this disease include:

  • Chronic renal failure
  • Deep venous thrombosis
  • End-stage renal disease
  • Nephrotic syndrome
  • Pulmonary embolism
  • Renal vein thrombosis

When should I contact a medical professional for Membranous Nephropathy?

Call for an appointment with your health care provider if:

  • You have symptoms of membranous nephropathy
  • Your symptoms get worse or don't go away
  • You develop new symptoms
  • You have decreased urine output

How do I prevent Membranous Nephropathy?

Quickly treating disorders and avoiding substances that can cause membranous nephropathy may reduce your risk.

Kidney

REFERENCES

Radhakrishnan J, Appel GB. Glomerular disorders and nephrotic syndromes. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 113.

Saha MK, Pendergraft WF, Jennette JC, Falk RJ. Primary glomerular disease. In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner and Rector's The Kidney. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 31.

Salant DJ, Cattran DC. Membranous nephropathy. In: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. Comprehensive Clinical Nephrology. 6th ed. Philadelphia, PA: Elsevier; 2019:chap 20.

Latest Research

Latest Advance
Study
  • Condition: Idiopathic Membranous Nephropathy
  • Journal: Medical archives (Sarajevo, Bosnia and Herzegovina)
  • Treatment Used: Immunosuppressive Drugs
  • Number of Patients: 1
  • Published —
The study researched the treatment of idiopathic membranous nephropathy.
Latest Advance
Study
  • Condition: Primary Membranous Nephropathy
  • Journal: The American journal of case reports
  • Treatment Used: Intravitreal Bevacizumab
  • Number of Patients: 1
  • Published —
The study researched the outcomes of a case of primary membranous nephropathy.

Clinical Trials

Clinical Trial
Drug
  • Status: Not yet recruiting
  • Study Type: Drug
  • Participants: 20
  • Start Date: November 2020
Acthar for Treatment of Post-transplant FSGS
Clinical Trial
Other
  • Status: Not yet recruiting
  • Study Type: Other
  • Participants: 375
  • Start Date: October 31, 2020
Nephrotic Syndrome Study Network (NEPTUNE) Match Study