[Clinical course in 51 patients with idiopathic membranous glomerulopathy]

51 patients, mainly adults, with idiopathic membranous glomerulonephropathy were studied to evaluate their clinical course and long-term prognosis. Glomerular lesions were classified into four groups, according to Ehrenreich and Churg: 5 had type I, 19 type II, 20 type III and 7 type IV lesions. The onset was marked by a nephrotic syndrome in 47 patients (92%). Hypertension was present in 41% and the serum creatinine was over 2 mg/dl in 17%. During the follow-up period (mean 42 months) clinical remission occurred in 7 cases, clinical improvement in 4 patients, renal insufficiency in 11 patients (with end-stage renal failure in 10 and the condition remained unchanged in 29 cases. The actuarial life-table survival at 5 and 15 years was 80% and 56% respectively, excluded the 5 patients with renal vein thrombosis. The retrospective comparison in patients who did (n = 29) or did not (n = 22) receive corticosteroids, shows a favorable outcome of treated patients. Poor prognostic indicators were: impaired renal function at time of diagnosis, and advanced histologic staging.