Treatment of Membranous Nephropathy in Kidney Transplant Recipients with Recurrent Disease
Clinical scenario
This protocol addresses membranous nephropathy (MN) that recurs following kidney transplantation. Recurrence of MN in a transplant recipient represents a distinct clinical challenge requiring a specific management approach distinct from de novo or native-kidney disease.
Key condition: history of kidney transplantation
In kidney transplant recipients who develop recurrent MN, maximal conservative antiproteinuric therapy forms the foundation of management. The transplant context shapes both therapeutic goals and the choice of further intervention when conservative measures are insufficient.
Treatment approach (partial)
When proteinuria exceeds a defined threshold, a targeted monoclonal antibody therapy is indicated as the next step. The full protocol specifies the precise criteria, selection considerations, and complete management pathway.
Full regimen available below
References
- Patients with recurrent MN should be treated with maximal conservative, antiproteinuric therapy.
- If proteinuria >1 g/d, we suggest treatment with rituximab.
DOI: 10.1016/j.kint.2021.05.015
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