Membranous nephropathy: the current state of the problem

Membranous nephropathy (MN) is an autoimmune disease of the kidney glomeruli and one of the leading causes of nephrotic syndrome. The disease exhibits heterogenous outcomes with approximately 30 % of cases progressing to end-stage renal disease. The study of MN pathogenesis has steadily advanced owing to the identification of autoantibodies to the phospholipase A2 receptor (PLA2R) in 2009 and thrombospondin domain-containing 7A (THSD7A) on the podocyte surface in 2014. Approximately 50–80 and 3–5 % of primary MN cases are associated with either anti-PLA2R or anti-THSD7A antibodies, respectively. The presence of these autoantibodies is used for MN diagnosis; antibody levels correlate with disease severity and possess significant biomarker values in monitoring disease progression and treatment response.