First-Line Treatment of Primary Membranous Nephropathy with Proteinuria

This protocol addresses patients with primary membranous nephropathy presenting with proteinuria. The initial approach focuses on conservative management while the natural course of the disease is carefully observed.

All patients receive optimal supportive care centred on a maximal antiproteinuric (conservative) strategy. The full structured regimen — specific interventions, titration, monitoring parameters, and escalation criteria — is contained in the complete protocol.

The primary target is spontaneous remission, defined by a sustained decrease in proteinuria alongside a rising serum albumin. Response is assessed at approximately 6 months.