About Membranous Nephropathy
Membranous nephropathy (MN) is an antibody-mediated glomerular disease in which IgG autoantibodies bind to antigens on the outer (subepithelial) side of the glomerular basement membrane, forming immune complexes that activate complement and thicken the filtration barrier. In about 70-80% of primary cases, the antibodies target the M-type phospholipase A2 receptor (PLA2R) on podocytes; another ~3-5% target thrombospondin type-1 domain-containing 7A (THSD7A). Other recently identified antigens (NELL-1, semaphorin-3B, exostosin) account for smaller subsets.
The clinical course varies widely: about one-third of patients remit spontaneously, one-third have persistent but stable proteinuria, and one-third progress to chronic kidney disease or end-stage kidney disease over years. Treatment has historically combined supportive care (ACE inhibitors, blood-pressure control, anticoagulation for high-risk patients) with immunosuppression in higher-risk patients — traditionally cyclophosphamide plus steroids, or rituximab (now considered first-line immunosuppression for most PLA2R-positive patients). Anti-PLA2R antibody levels are used to guide treatment intensity and monitor response. Emerging approaches under study include more selective B-cell depletion, complement inhibition, and targeted autoantibody degraders that selectively remove anti-PLA2R IgG.
Common Symptoms of Membranous Nephropathy
Recognizing the signs of Membranous Nephropathy early can lead to faster diagnosis and better outcomes. Symptoms may vary in severity from person to person. If you or a loved one are experiencing any of the following, consider speaking with a specialist.
- Heavy protein in the urine (foamy urine, proteinuria)
- Swelling in the legs, ankles, and around the eyes (edema)
- Weight gain from fluid retention
- High blood pressure
- Increased cholesterol and triglycerides
- Fatigue and a higher risk of blood clots
Who Membranous Nephropathy Affects
Primary membranous nephropathy is most common in adults ages 30-60, affects men about twice as often as women, and is the most common cause of non-diabetic nephrotic syndrome in White adults. Secondary membranous nephropathy can occur at any age and is linked to lupus, hepatitis B, certain cancers, or medications. Family history is rarely a factor for the primary form.
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Trusted Membranous Nephropathy Resources
Reputable organizations and medical references for learning more about Membranous Nephropathy, including disease registries, foundation resources, and clinical guidelines.
