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Membranous nephropathy is a frequent type of primary glomerular disease -- a disease affecting the glomerulus, the tiny ball-shaped structure in the kidney composed of capillary blood vessels that is actively involved in the filtration of the blood to form urine. The main sign of the disease is marked proteinuria (protein in the urine).
Disease pathophysiology:
MN is a discrete pathological entity which can be identified only by renal biopsy, including examination of the tissue by electron microscopy. The glomerular capillary wall is expanded, but the cellularity of the glomerulus is not typically increased. Immune deposits, typically including immunoglobulin (Ig) G and complement, are found in a granular distribution along the glomerular capillary wall .
Disease statistics:
The natural history of idiopathic membranous nephropathy and recurrent disease in transplants is variable. A retrospective cohort study of renal transplant recipients with a primary diagnosis of idiopathic membranous nephropathy. A detailed medical chart review was performed in all cases, and a senior renal histopathologist reviewed all histology specimens. Results. The outcomes of 32 patients, in receipt of 36 grafts, are reported. There was no significant association between time on dialysis, HLA mismatch, occurrence of rejection, and the development of recurrent membranous disease.
Disease treatment:
The possibility that any form of specific therapy can alter the natural course of IMN is still debated among nephrologists. Glucocorticoids and immunosuppressiveagents have been largely used in IMN with different results. More recently cyclosporine has also been tried, but the experience with this agent is still preliminary. Moreover, the criteria for treatment, the types and the duration of treatment, and the characteristics of patients considered were extremely variable in the different studies.
Major research on disease:
Transplant Outcomes in Patients with Idiopathic Membranous Nephropathy by Department of Nephrology and Department of Histopathology, Beaumont Hospital, Dublin 9, Ireland. In approximately 25% of cases the disease is secondary, being greater the percentage in children and elderly patients.
