[Membranous glomerulonephritis--recent advances in pathogenesis and treatment]

Abstract

Membranous glomerulonephritis is one of the leading causes of nephrotic syndrome in adults. It may have very variable course, with some patients slowly progressing to renal failure and some entering spontaneous remission. The aim of this article is to review recent advances in the pathogenesis and treatment of the disease in recent years. In recent years, first human podocyte autoantigens, responsible for autoantibodies and in situ immune complexes formation, were discovered: neutral endopeptidase, m-type phospholipase A2 receptor, superoxide-dismutase 2, aldose-reductase, alpha-enolase. It is postulated that these discoveries will help in differentiation between primary and secondary membranous glomerulonephritis, in predicting remission and/or relapse and also in determining more specific therapy. There have been also some pilot studies recently, in which new drugs have been introduced in the treatment of membranous glomerulonephritis: ACTH, rituximab and tacrolimus.