Membranoproliferative glomerulonephritis medical therapy

The optimal therapy for membranoproliferative glomerulonephritis depends on underlying etiology. In infectious and haematological etiology treating the underlying infection will result in resolution of membranoproliferative glomerulonephritis.For autoimmune etiology immunosuppressive agents are given.The treatment also includes antihypertensive therapy, anticoagulation therapy and anti-lipid therapy for nephrotic syndrome.

• Pharmacologic therapy is recommended for patients of membranoproliferative glomerulonephritis. Treatment options depends upon underlying etiology.^[1][2][3][4]
• Patients with autoimmune etiology are treated with immunosuppressive therapy.
• Patients with infectious etiology are treated with antivirals or antibiotics .
• Hepatitis B and Hepatitis C are treated with antivirals.
  • Leukemias and lymphomas treated with chemotherapy.
• Other pharmacologic medical therapies for membranoproliferative glomerulonephritis include antihypertensive therapy, anticoagulation therapy and anti-lipid therapy.

1. Patients with autoimmune etiology

• 1.1 Immunosuppressive therapy:
  • Preferred regimen (1): Prednisone 0.5 mg/kg per day with cyclophosphamide IV for 3-5 months
  • Preferred regimen (2): Methylprednisolone 0.4 mg/kg per day given with cyclophosphamide 2.0 to 2.5 mg/kg per day given IV for 2, 4, and 6 months
  • Preferred regimen (3): Tacrolimus 0.05 mg/kg per day for PO for 12 months with a six-month taper
  • Preferred regimen (4): Rituximab 3.5g/day IV for 6-12 months
• 2. Treatment for nephrotic sydnrome:
  • 2.1 Antihypertensive therapy
    • Preferred regimen (1) Losartan PO for 50 mg q daily (100mg per day)
  • 2.2 Anticoalgulation tharapy
    • Low molecular weight or unfractionated heparin, followed by PO warfarin.
  • 2.3 Anti-lipid therapy
    • 2.3.1 Life-style modification
      • Decrease salt intake
      • Weight loss
    • 2.3.2 Statins
      • Preferred regimen (1): Atorvastatin PO 10mg q daily

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