Primary membranous nephropathy in Singapore over the past decade and response to therapy

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OBJECTIVE: This is a single-center retrospective cohort study on the demographics and clinical outcomes including the response to therapy of patients with primary membranous nephropathy (PMN) over the past decade. With the spread of diverse therapeutic agents available today, this study seeks to present an interesting array of varied responses. MATERIALS AND METHODS: All histology-proven PMN cases diagnosed between 2008 and 2018 were analyzed for their clinical, laboratory, and histological characteristics including treatment that could influence disease progression and renal outcome. RESULTS: There were two sub-groups of patients, those with nephrotic syndrome and those without nephrotic syndrome. All secondary causes of secondary membranous nephropathy were excluded. The response to therapy including RAS blockers, steroids, and immunosuppressants all showed a consistent reduction of proteinuria with therapy for the whole cohort, nephrotic as well as non-nephrotic syndrome with only 10% of the 102 patients in end-stage renal disease (ESRD) at 10 years. CONCLUSION: Our data show that membranous nephropathy is a disease responsive to most forms of therapy with decreasing proteinuria. The progression of the disease is slow with a gradual decline to ESRD.

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