Role of immunosuppressive drugs in Membranous Nephropathy
The ideal treatment option in patients with primary Membranous Nephropathy remains unclear, and use of immunosuppression is controversial.
This is partly due to the variable natural history of the disease and the risks associated with drug toxicity.
Immunosuppression is generally reserved for those patients with deteriorating kidney function or heavy proteinuria that persists despite conservative treatment or those with high anti-PLA 2 R antibody titers.
Various agents have been used including corticosteroids, cyclophosphamide, chlorambucil, mycophenolate mofetil, calcineurin inhibitors (e.g., cyclosporine, tacrolimus), rituximab, and adrenocorticotropic hormone (ACTH) with variable success.
