Nonimmunosuppressive therapy of membranous nephropathy

Semin Nephrol. 2003 Jul;23(4):333-9. doi: 10.1016/s0270-9295(03)00050-0.


Idiopathic membranous nephropathy (MN) has a variable rate of progression to end-stage renal failure, with a significant number of patients going into spontaneous remission without therapy. For those who have persistent nephrotic proteinuria or manifest deterioration of renal function, steroids and immunosuppressive drugs are used. However, their long-term efficacy is challenged by a meta-analysis presented here. A different approach to reduction of proteinuria, a recognized progression promoter, is based on the notion that angiotensin II inhibition controls proteinuria and slows progression. Further, a more complex approach is required than simple administration of an angiotensin-converting enzyme (ACE) inhibitor: a multidrug approach to remission of nephrotic syndrome therefore is described here.

Publication types

  • Comparative Study
  • Meta-Analysis

MeSH terms

  • Adult
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Antihypertensive Agents / therapeutic use
  • Calcium Channel Blockers / therapeutic use
  • Endpoint Determination
  • Glomerulonephritis, Membranous / drug therapy*
  • Humans
  • Proteinuria / drug therapy*
  • Randomized Controlled Trials as Topic
  • Treatment Outcome


  • Angiotensin-Converting Enzyme Inhibitors
  • Antihypertensive Agents
  • Calcium Channel Blockers