Long-term prognosis of idiopathic membranous glomerulonephritis

The Natural History of the Non-Nephrotic Membranous Nephropathy Patient

“…The largest natural history study was published in 1979 and included 116 untreated patients with MGN, of which 28 (24.2%) presented with subnephrotic range proteinuria. However, the outcome for this subgroup of patients was not described, and almost 25% of the patients were followed for less than 1 yr (2). In other studies, between 15 and 46% of patients presented with subnephrotic range proteinuria (6,14,17).…”

“…The natural history of the disease is stated to ascribe to the rule of thirds, wherein approximately one-third of the affected have a complete and spontaneous remission of their proteinuria, onethird enter a partial remission with subnephrotic range proteinuria, and a final third remain nephrotic and progress to end-stage renal disease (ESRD) (1)(2)(3)(4). Studies utilizing multivariate analysis techniques have identified clinical predictors of poor renal survival.…”

“…These include older age, male gender, and elevated serum creatinine at the time of diagnosis as well as the severity of proteinuria at the time of disease onset and during follow-up (5-10). However, despite these known predictors, the long-term outcome is variable with the 10 yr renal survival ranging from 60 to 80% (1)(2)(3)(4). Thus, the optimal strategy for the management of patients with MGN has remained unclear with varying opinions emerging in the literature (11)(12)(13).…”

Minimal change nephropathy associated with anaplastic carcinoma of bronchus

“…No particular type of carcinoma predominated and survival after tumour diagnosis was short (median 3 months), few patients having remission of their nephrotic syndrome. Others have reported that between 2 and 10% ofpatients with membranous nephropathy are subsequently found to have carcinoma (Row et al, 1975;Noel et al, 1979;Tu et al, 1984). A few patients with carcinoma in association with proliferative, crescentic and membranoproliferative glomerulonephritis have also been reported (Hopper et al, 1975;Tydings et al, 1978;Jermanovich et al, 1982).…”

Renal Artery Thrombosis in a Patient with Membranous Glomerulonephritis.

“…These complications may involve life-threatening episodes or may be responsible for intractability to glucocorticoid treatment. Renal vein thrombosis (RVT) has frequently been observed, especially in membranous glomerulonephritis (MGN) (2) and in certain steroid-resistant cases. Anticoagulants such as heparin or warfarin, have frequently been used in combination with glucocorticoids in the treatment of RVT, and favorable effects in the improvement of renal function and reduction of proteinuria have been observed (3,4).…”