Treatments for Membranous Nephropathy

Common Treatment

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 mmHg. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are the medicines most often used to lower blood pressure.

Corticosteroids and other drugs that suppress the immune system may be used.

High blood cholesterol and triglyceride levels should be treated to reduce the risk of atherosclerosis. However, a low-fat, low-cholesterol diet is usually not as helpful for people with membranous nephropathy. Medications to reduce cholesterol and triglyceride levels (most often statins) may be recommended.

A low-salt diet may help with swelling in the hands and legs. Water pills or diuretics may also help with this problem.

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

Vitamin D may need to be replaced if nephrotic syndrome is chronic and does not respond to therapy.

This disease increases the risk for blood clots in the lungs and legs. Patients are occasionally prescribed blood thinners to prevent these complications.

However, the above treatment only can alleviate the symptoms of Membranous Nephropathy, it can’t treat this disease from the root.

Exams and Tests
A physical exam may show swelling (edema).

A urinalysis may reveal large amounts of protein in the urine. There may also be some blood in the urine. The glomerular filtration rate (the "speed" at which the kidneys cleanse the blood) is usually nearly normal.

Other tests may be done to see how well the kidneys are working and how the body is adapting to the kidney problem. These include:

Albumin - blood and urine

Blood urea nitrogen (BUN)

Creatinine - blood

Creatinine clearance

Lipid panel

Protein - blood and urine

A kidney biopsy confirms the diagnosis.

The following tests can help determine the cause of membranous nephropathy:

Antinuclear antibodies test

Anti-double-strand DNA, if the antinuclear antibodies test is positive

Blood tests to check for hepatitis B, hepatitis C, and syphilis

Complement levels

Cryoglobulin test