Membranous nephropathy

Etiology

• Primary/idiopathic
• Cancer (non-Hodgkin lymphoma and solid tumours)
• Drugs (gold and penicillamine)
• Infections (malaria, HBV, HCV)
• Lupus

Management

Non-immunosuppressive

• ACEi/ARB
• Statin
• Thromboprophylaxis (high risk)

Immunosuppressive

Low risk

• No need for immunosuppressing medications

Moderate risk

• Prednisone with cyclophosphamide
• Alternatives include cyclosporine/tacrolimus with prednisone
• Second-line is rituximab