Membranous nephropathy (MN) is a common cause of adult nephrotic syndrome, yet individual treatment decisions remain challenging owing to the possibility of spontaneous remission, risk of progressive loss of kidney function, and toxicities from immunosuppression. This is further complicated because clinical outcomes, both remission of proteinuria and worsening kidney function, evolve over years. Well-established baseline risk factors associated with higher risk of progression include male sex, sustained heavy proteinuria, and lower estimated glomerular filtration rate.