Membranous nephropathy
Description
- Subepithelial immune complex deposition on the podocyte side of the GBM -> thickened capillary wall, no inflammatory infiltrate
- Deposits are outside the endothelium, so there is no cellular reaction and no nephritic picture
- Commonest cause of primary nephrotic syndrome in white adults over 50
- ~80% primary (autoantibody-mediated), ~20% secondary
- The most thrombogenic glomerular disease
The rule of thirds (untreated)
- 1/3 spontaneous remission (up to 30-40% over 5 yrs)
- 1/3 persistent proteinuria, stable function
- 1/3 progressive -> ESKD
6 more sections, plus exam facts
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