Can Membranous Nephropathy Be Cured or Just Managed with Medications? - Internal Medicine

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Membranous nephropathy (MN) is a kidney disorder characterized by the presence of immune complex deposits on the glomerular basement membrane, leading to nephron damage and proteinuria. The question of whether MN can be cured or merely managed with medications is complex and depends on various factors, including the underlying cause of the condition, the severity of the disease, and the individual patient's response to treatment.

In many cases, membranous nephropathy can be managed effectively with medications, but it is important to note that a complete cure is not always possible. The primary goal of treatment is to reduce proteinuria, preserve kidney function, and manage any associated symptoms or complications. Commonly used medications include corticosteroids, immunosuppressants (such as cyclophosphamide or mycophenolate mofetil), and calcineurin inhibitors (like cyclosporine). These medications can help to reduce inflammation and immune response, potentially leading to remission of proteinuria and stabilization of kidney function.

In your case, you mentioned that you have been on medication for nearly two years, specifically cyclosporine (200 mg) and mycophenolate mofetil (360 mg). The presence of a urine albumin-to-creatinine ratio of 14.1 and microalbumin levels of 2.9 indicates ongoing proteinuria, which is a common feature of MN. The fact that your serum creatinine levels are fluctuating between 0.9 and 1.0 suggests that your kidney function is relatively stable, but the persistent proteinuria is concerning.

It is essential to have regular follow-ups with your nephrologist to monitor your kidney function and protein levels. The treatment plan may need to be adjusted based on your response to the current medications. In some cases, if proteinuria persists despite adequate treatment, additional therapies may be considered, such as rituximab, which has shown promise in treating MN.

Regarding your question about whether you can expect a complete recovery, it is important to understand that while some patients achieve remission and have normal protein levels, others may continue to experience some degree of proteinuria and require ongoing management. The prognosis can vary widely among individuals, and factors such as the underlying cause of MN (primary vs. secondary) and the presence of other comorbidities can influence outcomes.

In summary, membranous nephropathy is typically managed with medications rather than being completely cured. Regular monitoring and adjustments to your treatment plan are crucial for optimizing your kidney health. It is advisable to maintain open communication with your healthcare provider about your symptoms, medication side effects, and any concerns you may have regarding your condition. They can provide personalized recommendations based on your specific situation and help you navigate the complexities of managing this condition.