What is it about?

This is a review article that covers new insights into the causes of primary membranous nephropathy, the recently discovered biologic mechanisms involved in producing kidney injury and disease and the approaches to treatment that target those mechanisms and produce the best outcomes as documented in clinical trials.

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Why is it important?

Membranous nephropathy is the most common cause of nephrotic syndrome (high levels of protein leaking from the kidney into the urine) in adults. How we understand the mechanisms that cause this disease has been transformed in the past decade. These new mechanisms will likely shed light on how other diseases of the kidney are caused. This review covers the new research findings that clarify how kidney glomeruli are injured in this disease and the approaches to treatment that are now used based on the newer findings.

Perspectives

I have spent my entire research career in nephrology, some 34 years, studying the pathogenesis of primary membranous nephropathy using animal models that closely mimic human disease. During this time I have also cared for many patients with this disease. Some of the discoveries made in my laboratory have led directly to the recent studies in man that have now defined the immunologic mechanisms that cause kidney damage and progressive kidney failure in membranous nephropathy. These studies have defined MN as an autoimmune disease in man and led to new approaches to therapy. This fulfills the dream of every research doctor that their findings will lead to improved diagnosis and treatment of human disease.

William Couser
University of Washington

Read the Original

This page is a summary of: Primary Membranous Nephropathy, Clinical Journal of the American Society of Nephrology, May 2017, American Society of Nephrology,
DOI: 10.2215/cjn.11761116.
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