Management of idiopathic membranous nephropathy.

IMPORTANCE OF THE FIELD: Idiopathic membranous nephropathy (IMN) can have a variable natural course. Treatments able to induce remission can improve the long-term prognosis. However, the optimal therapy for IMN remains controversial. AREA COVERED IN THIS REVIEW: We reviewed the historical and current literature from 1979 to 2010 regarding the natural course of IMN and the possible treatments giving special emphasis to randomized controlled trials and to more recent approaches. WHAT THE READER WILL GAIN: The reader will gain a comprehensive review of the available treatments of IMN. A personal therapeutic algorithm for nephrotic patients with IMN is also provided. TAKE HOME MESSAGE: At least five different treatments showed efficacy in many (but not all) patients with IMN.