What is the second line treatment for Membranoproliferative glomerulonephritis?
There is a compelling argument in favor of optimal control of blood pressure, preferably with an ACEI or ARB.
Plasmapheresis has been reported to be useful in small numbers of patients with severe idiopathic Membranoproliferative glomerulonephritis and acute kidney failure or rapidly deteriorating disease.
Mycophenolate mofetil has been tried in patients with cryoglobulinemic Membranoproliferative glomerulonephritis related to hepatitis B infection.
Although treatment resulted in reduced proteinuria, viral replication was induced by the drug. Therefore caution is advisable when considering this immunosuppressive agent for the treatment of Membranoproliferative glomerulonephritis.
Mycophenolate mofetil has also been utilized in open-label studies of patients with type II Membranoproliferative glomerulonephritis and C3 glomerulopathy.
Cyclosporine is another alternative form of immunosuppressive therapy that may be beneficial in patients with refractory Membranoproliferative glomerulonephritis; however, it has not been studied systematically in a large case series.
