Renal
Membranous Nephropathy
Anti-PLA2R, primary vs secondary, KDIGO risk-based therapy (rituximab/cyclophosphamide+steroid/calcineurin inhibitor).
Source: KDIGO 2021 GN
Step 1 of ~6
info
Diagnosis
Nephrotic syndrome in adults — most common primary cause. Bloods: anti-PLA2R antibodies (positive in 70–80% of primary), anti-THSD7A (5%); albumin (low), cholesterol (high), creatinine, hepatitis B/C, HIV, ANA. Renal biopsy: thickened GBM, sub-epithelial deposits, IgG / C3 IF, electron microscopy spikes. Always exclude secondary cause: malignancy (especially in elderly — age-appropriate cancer screen), infections (hepatitis B), drugs (NSAIDs, gold, captopril, penicillamine), autoimmune (SLE).
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Ianalumab (Anti-BAFF — Primary Sjögren's Syndrome) · Anti-BAFF Monoclonal Antibody (B-Cell Survival Factor Inhibitor)
- Tacrolimus (Topical) · Topical calcineurin inhibitor (TCI)
- Pimecrolimus · Calcineurin Inhibitor (Topical)
- Belimumab (Cutaneous Lupus) · BLyS/BAFF Inhibitor (Anti-B-Lymphocyte Stimulator)
- Denosumab · RANK Ligand Inhibitor (Anti-resorptive)
- Dupilumab (CRSwNP) · IL-4Rα Inhibitor (Anti-IL-4/IL-13)
Pathways
- Hyperkalaemia Management · UK Kidney Association Guidelines 2020; NICE CKD Guidelines
- Rhabdomyolysis · Renal Association 2018; UpToDate 2024
- Hypocalcaemia (Adult) · Society for Endocrinology
- SIADH (Endocrine Perspective) · European Hyponatraemia Guidelines 2014
- Hepatorenal Syndrome · EASL 2018; ICA 2015
- Acute Kidney Injury (AKI) · KDIGO 2012 / NICE AKI 2019
Decision support only. Always apply local guidelines and clinical judgement.