Authors: Ponticelli C, Passerini P
Idiopathic membranous nephropathy (IMN) may have a variable course, with some patients entering spontaneous remission and others slowly progressing to renal failure. The disease is treatable, but the available treatments are not devoid of potential morbidity. We review the studies dedicated to finding prognostic markers. Although a number of clinical and histologic markers are associated with an increased risk of progression to renal failure, in many cases it is still impossible to recognize at presentation what will be the long-term outcome for a patient with IMN. More reliable are time-dependent predictors, such as the amount of proteinuria over time and complete or partial remission. However, this means that a physician should wait for months or ev...