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How to Choose the Right Treatment for Membranous Nephropathy
Membranous nephropathy is an autoimmune disease affecting the glomeruli and is one of the most common causes of nephrotic syndrome. In the absence of any therapy, 35% of patients develop end-stage renal disease. The discovery of autoantibodies such as phospholipase A2 receptor 1, antithrombospondin...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10673286/ https://www.ncbi.nlm.nih.gov/pubmed/38004046 http://dx.doi.org/10.3390/medicina59111997 |
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author | Peritore, Luigi Labbozzetta, Vincenzo Maressa, Veronica Casuscelli, Chiara Conti, Giovanni Gembillo, Guido Santoro, Domenico |
author_facet | Peritore, Luigi Labbozzetta, Vincenzo Maressa, Veronica Casuscelli, Chiara Conti, Giovanni Gembillo, Guido Santoro, Domenico |
author_sort | Peritore, Luigi |
collection | PubMed |
description | Membranous nephropathy is an autoimmune disease affecting the glomeruli and is one of the most common causes of nephrotic syndrome. In the absence of any therapy, 35% of patients develop end-stage renal disease. The discovery of autoantibodies such as phospholipase A2 receptor 1, antithrombospondin and neural epidermal growth factor-like 1 protein has greatly helped us to understand the pathogenesis and enable the diagnosis of this disease and to guide its treatment. Depending on the complications of nephrotic syndrome, patients with this disease receive supportive treatment with diuretics, ACE inhibitors or angiotensin-receptor blockers, lipid-lowering agents and anticoagulants. After assessing the risk of progression of end-stage renal disease, patients receive immunosuppressive therapy with various drugs such as cyclophosphamide, steroids, calcineurin inhibitors or rituximab. Since immunosuppressive drugs can cause life-threatening side effects and up to 30% of patients do not respond to therapy, new therapeutic approaches with drugs such as adrenocorticotropic hormone, belimumab, anti-plasma cell antibodies or complement-guided drugs are currently being tested. However, special attention needs to be paid to the choice of therapy in secondary forms or in specific clinical contexts such as membranous disease in children, pregnant women and patients undergoing kidney transplantation. |
format | Online Article Text |
id | pubmed-10673286 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-106732862023-11-14 How to Choose the Right Treatment for Membranous Nephropathy Peritore, Luigi Labbozzetta, Vincenzo Maressa, Veronica Casuscelli, Chiara Conti, Giovanni Gembillo, Guido Santoro, Domenico Medicina (Kaunas) Review Membranous nephropathy is an autoimmune disease affecting the glomeruli and is one of the most common causes of nephrotic syndrome. In the absence of any therapy, 35% of patients develop end-stage renal disease. The discovery of autoantibodies such as phospholipase A2 receptor 1, antithrombospondin and neural epidermal growth factor-like 1 protein has greatly helped us to understand the pathogenesis and enable the diagnosis of this disease and to guide its treatment. Depending on the complications of nephrotic syndrome, patients with this disease receive supportive treatment with diuretics, ACE inhibitors or angiotensin-receptor blockers, lipid-lowering agents and anticoagulants. After assessing the risk of progression of end-stage renal disease, patients receive immunosuppressive therapy with various drugs such as cyclophosphamide, steroids, calcineurin inhibitors or rituximab. Since immunosuppressive drugs can cause life-threatening side effects and up to 30% of patients do not respond to therapy, new therapeutic approaches with drugs such as adrenocorticotropic hormone, belimumab, anti-plasma cell antibodies or complement-guided drugs are currently being tested. However, special attention needs to be paid to the choice of therapy in secondary forms or in specific clinical contexts such as membranous disease in children, pregnant women and patients undergoing kidney transplantation. MDPI 2023-11-14 /pmc/articles/PMC10673286/ /pubmed/38004046 http://dx.doi.org/10.3390/medicina59111997 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Peritore, Luigi Labbozzetta, Vincenzo Maressa, Veronica Casuscelli, Chiara Conti, Giovanni Gembillo, Guido Santoro, Domenico How to Choose the Right Treatment for Membranous Nephropathy |
title | How to Choose the Right Treatment for Membranous Nephropathy |
title_full | How to Choose the Right Treatment for Membranous Nephropathy |
title_fullStr | How to Choose the Right Treatment for Membranous Nephropathy |
title_full_unstemmed | How to Choose the Right Treatment for Membranous Nephropathy |
title_short | How to Choose the Right Treatment for Membranous Nephropathy |
title_sort | how to choose the right treatment for membranous nephropathy |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10673286/ https://www.ncbi.nlm.nih.gov/pubmed/38004046 http://dx.doi.org/10.3390/medicina59111997 |
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