Membranous Nephropathy

About

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Membranous nephropathy (MN) is a kidney disorder characterized by thickening of the glomerular basement membrane due to immune complex deposition. This process causes damage to the glomeruli, resulting in proteinuria(excess protein in the urine), edema, and, in some cases, progressive kidney dysfunction.

MN is one of the most common causes of nephrotic syndrome in adults. It can occur primarily (idiopathic) or secondarily due to infections, autoimmune disorders, medications, or malignancies. Early diagnosis is essential to preserve kidney function and prevent complications.

Is it common?

MN is relatively common among adults with nephrotic syndrome, accounting for approximately 20–30% of adult cases. It is more frequently diagnosed in individuals aged 30–60 years and is slightly more common in men than women.

Can it be cured?

There is no guaranteed cure for MN. Some patients experience spontaneous remission, especially those with mild proteinuria, while others require immunosuppressive therapy to control protein loss and prevent progression to chronic kidney disease. Close monitoring of kidney function and proteinuria is essential to guide treatment.

Causes

What causes Membranous Nephropathy?

Primary (Idiopathic) MN

  • Caused by autoantibodies targeting the phospholipase A2 receptor (PLA2R) on podocytes
  • Leads to immune complex deposition and glomerular damage

Secondary MN

  • Infections: hepatitis B, hepatitis C, syphilis
  • Autoimmune disorders: lupus, rheumatoid arthritis
  • Medications: NSAIDs, gold therapy, penicillamine
  • Cancer: solid tumors (lung, colon, breast)

Risk factors such as age, genetic predisposition, and comorbidities may influence disease severity and progression.

With Insurance

Nephrology

Your copay
Depending on insurance

Without Insurance

*Price Effective 12/1/2025
$169
Initial Visit
$109
Follow Up

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Symptoms

MN may remain asymptomatic initially and is often detected via routine urine testing. When symptoms appear, they may include:

  • Proteinuria (foamy urine, hallmark feature)
  • Edema (swelling in legs, feet, or around eyes)
  • Hypoalbuminemia (low blood protein)
  • Hyperlipidemia (high cholesterol)
  • Fatigue
  • In advanced cases: progressive kidney dysfunction or chronic kidney disease

Diagnosis

Diagnosis involves laboratory tests, imaging, and kidney biopsy:

Laboratory Tests

  • Urinalysis: detects proteinuria, hematuria
  • Blood tests: serum creatinine, BUN, eGFR, albumin levels
  • Serology: PLA2R antibodies (primary MGN), screening for infections or autoimmune diseases

Imaging

  • Kidney ultrasound to rule out structural abnormalities

Kidney Biopsy

  • Definitive diagnostic tool
  • Shows thickened glomerular basement membrane with subepithelial immune deposits
  • Immunofluorescence or electron microscopy helps distinguish primary vs secondary MGN

Treatment

Treatment is individualized based on severity, proteinuria, and underlying cause:

Supportive Care

  • ACE inhibitors or ARBs to reduce proteinuria and control blood pressure
  • Diuretics for edema
  • Low-salt diet and lifestyle measures
  • Cholesterol-lowering medications if hyperlipidemia is present

Immunosuppressive Therapy

  • Corticosteroids (prednisone)
  • Cyclophosphamide, cyclosporine, or rituximab in selected patients with persistent proteinuria or progressive disease

Treatment of Secondary Causes

  • Address underlying infection, autoimmune disorder, medication, or malignancy

Advanced Interventions

  • Dialysis for end-stage kidney disease
  • Kidney transplantation in irreversible kidney failure

With early detection and proper management, many patients maintain stable kidney function and reduce the risk of progression to chronic kidney disease.

References

  • Kidney Disease: Improving Global Outcomes (KDIGO) 2021 Clinical Practice Guideline for Glomerular Diseases
  • National Kidney Foundation – Membranous Glomerulonephritis Overview
  • Mayo Clinic – Membranous Nephropathy: Symptoms, Diagnosis, and Treatment
  • American Society of Nephrology (ASN) – MGN Resources
  • UpToDate – “Membranous Nephropathy: Clinical Features and Management”
  • StatPearls – Membranous Glomerulonephritis Review
  • NIDDK – Kidney Diseases Overview
  • European Renal Association (ERA-EDTA) – Glomerular Disease Guidelines

Medically reviewed by:

Dr. Javeed Siddiqui, MD, MPH

Dr. Siddiqui is the Chief Medical Officer at TeleMed2U responsible for clinical and technical program development as well as maintaining a thriving telemedicine practice in infectious diseases which includes specialized care of Hepatitis and HIV.

Meet our doctors

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Affordable – with or without insurance

With Insurance

Nephrology

Your copay
Depending on insurance

Without Insurance

*Price Effective 12/1/2025
$169
Initial Visit
$109
Follow Up

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