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SHR Neuro Cancer Cardio Lipid Metab Microb

Säemann, MD; Odler, B; Windpessl, M; Regele, H; Eller, K; Neumann, I; Rudnicki, M; Gauckler, P; Kronbichler, A; Knechtelsdorfer, M.
[Diagnosis and therapy of membranous nephropathy-2023].
Wien Klin Wochenschr. 2023; 135(Suppl 5): 648-655. Doi: 10.1007/s00508-023-02261-w [OPEN ACCESS]
Web of Science PubMed FullText FullText_MUG

 

Co-authors Med Uni Graz

Eller Kathrin

Odler Balazs

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Abstract:

Membranous nephropathy (MN) is an immune-complex glomerulonephritis and is one of the most common causes of nephrotic syndrome in adults and is also one of the autoimmune kidney diseases with the highest rate of spontaneous remission. The most common autoantigen (> 70% of cases) is directed against the phospholipase A2 receptor (PLA2-R) and, with its detection and clinical course, allows for excellent diagnostics as well as optimal therapy monitoring. Other autoantigens are constantly being published and will enable an autoantigen-based diagnostic and therapeutic algorithm for MN in the future. In the absence of spontaneous remission, a specific B‑cell-directed therapy, especially with rituximab, is the initial therapy of choice. Calcineurininhibitors or cyclophosphamide should only be used if they are carefully indicated in the respective clinical context and if there are serious clinical consequences both from the nephrotic syndrome and from loss of kidney function. Since immune complexes within the kidney often require a long time to be degraded, proteinuria response can follow the immunological remission after many months. The therapy of MN represents the favorable case of a precision medicine-based therapy in nephrology, whereby new therapeutic B‑cell antibodies for the rare but difficult forms of MN will find their way into clinical routine in the not-too-distant future.

Find related publications in this database (using NLM MeSH Indexing)

Adult - administration & dosage

Humans - administration & dosage

Glomerulonephritis, Membranous - diagnosis, therapy

Remission, Spontaneous - administration & dosage

Nephrotic Syndrome - diagnosis, therapy

Kidney - administration & dosage

Autoimmune Diseases - administration & dosage

Autoantigens - administration & dosage

Find related publications in this database (Keywords)

Nephrotisches Syndrom

Primare membranose Nephropathie

PLA2-Rezeptor-Autoantikorper

IgG-Subtyp 4

SGLT-2-Inhibitor

Nephrotic syndrome

Primary membranous Nephropathy

PLA2-receptor autoantibodies

IgG-subtype 4

SGLT-2-inhibitor

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