Membranoproliferative glomerulonephritis medical therapy

Membranoproliferative glomerulonephritis Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Ali Poyan Mehr, M.D. [2] Associate Editor(s)-in-Chief: Olufunmilola Olubukola M.D.[3]

Medical Therapy

• Pharmacologic medical therapy is recommended for patients of membranoproliferative glomerulonephritis.
• The treatment depends on the cause of the disease.
• Patients with autoimmuneetiology are treated with immunosuppressive therapy
• Patients with infectious etiology are treated with antivirals or antibiotics depending on the cause.
• 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

• Atorvastatin PO 10mg q daily