Membranous Nephropathy: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Membranous Nephropathy?
A nephrologist, a doctor who specializes in kidney disease, usually leads care for membranous nephropathy. Your kidney doctor may follow you closely to see whether the disease goes into remission, which means it stops being active. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is membranous nephropathy?
Membranous nephropathy is a kidney disorder. It changes and inflames the parts inside the kidney that filter wastes and fluids. The inflammation may lead to problems with kidney function.
A part of the kidney called the glomerular basement membrane becomes thick. It then does not work normally. Large amounts of protein are lost in the urine. In this disease the immune system attacks the kidney filters, so it is an autoimmune disease.
It is one of the most common causes of nephrotic syndrome. Nephrotic syndrome is a group of symptoms and test results. They include protein in the urine, low blood protein, high cholesterol and triglycerides, a higher risk of blood clots, and swelling.
Symptoms
Symptoms often begin slowly over time, so you may not notice anything is wrong. They may include:
- Swelling, called edema, in any area of the body, such as the legs, ankles, and around the eyes.
- Fatigue.
- Foamy-looking urine, caused by large amounts of protein.
- Poor appetite.
- Needing to urinate a lot at night.
- Weight gain.
Tests may also show high cholesterol and low protein levels in the blood.
Causes and who gets it
There are two kinds. Primary, or idiopathic, membranous nephropathy is more common. Researchers still need to find out what triggers the immune system in primary disease. Secondary membranous nephropathy is caused by another disease or a drug.
Things that raise the risk include:
- Cancers, especially lung and colon cancer.
- Exposure to toxins, including gold and mercury.
- Infections, including hepatitis B, malaria, syphilis, and endocarditis.
- Medicines, including penicillamine, trimethadione, and skin-lightening creams.
- Autoimmune disorders, including lupus, rheumatoid arthritis, and Graves disease.
The disorder can occur at any age, but it is more common after age 40. It is very rare in children.
How doctors diagnose it
A urine test may show a large amount of protein and sometimes some blood. Blood tests check how well the kidneys work, along with albumin and cholesterol levels. A kidney biopsy confirms the diagnosis. In this test, a tiny piece of kidney is removed with a special needle. It is then looked at under a microscope.
Imaging such as an ultrasound or CT scan can show the shape and size of the kidneys. Other tests can help find the cause. These include an antinuclear antibodies test and blood tests for hepatitis B, hepatitis C, and syphilis.
Treatment
The goal is to reduce symptoms and slow the disease. After diagnosis, your doctor may watch you closely without strong drugs. This gives time to see if the disease goes into remission. During this time you get supportive care, which has little or no risk. It includes:
- An ACE inhibitor or an ARB, medicines that lower blood pressure and protein loss.
- Diuretics, also called water pills.
- A low-salt diet, which can help swelling.
Controlling blood pressure is the most important way to delay kidney damage. If your symptoms do not go away, you may be given treatments that affect your immune system, such as corticosteroids. Statins can lower cholesterol and triglycerides. Blood thinners may be used to lower the risk of blood clots in the lungs and legs. A low-protein diet may help.
Talk with your provider about side effects of every treatment. If the kidneys fail, a transplant or dialysis may be needed.
When to see a doctor
Contact your provider if you have symptoms of membranous nephropathy. Also call if symptoms get worse or do not go away, or if you have new symptoms. Tell your provider if you pass less urine than before.
This disease raises the risk of blood clots in the lungs and legs.
Call 911 or go to the emergency room if you have trouble breathing, chest pain, fainting, or a sudden change in mental status such as confusion or being hard to wake up.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either can review your symptoms, help arrange urine and blood tests, and coordinate care with a kidney specialist.
Common questions
Is membranous nephropathy an autoimmune disease?
Yes, it is described as an autoimmune disease. In an autoimmune disease, the body's defense system turns against the body. In membranous nephropathy, the immune system attacks the kidney filters.
Can membranous nephropathy go away on its own?
Sometimes it can. The condition sometimes goes away with or without treatment. Some people go into spontaneous remission, which means the disease suddenly goes away without treatment.
Will membranous nephropathy cause kidney failure?
Not always. Over time some people get worse until kidney failure and then need a transplant or dialysis. Others respond well to treatment and live with the disease for many years while being monitored.
Can children get membranous nephropathy?
Yes, but it is very rare. If a child needs treatment, it is usually the same as for adults.
Sources
- MedlinePlus - Membranous nephropathy
- National Kidney Foundation - Membranous Nephropathy (MN)
- NIDDK - Glomerular Disease
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
