The presence of certain risk factors in a patient with membranous glomerulonephritis may be associated with a poor prognosis.


Factors associated with a worse prognosis:

(1) occurrence in an adult

(2) male gender

(3) very low serum albumin

(4) profuse and persistent proteinuria for months (> 4 grams per day for 18 months, > 8 grams per day for 6 months)

(5) hypertension

(6) impaired renal function

(7) failure to achieve a remission (spontaneous or therapy-induced)

(8) presence on HLA typing of DR3, DR5 or B37


Having a complete remission was associated with a good prognosis.


Findings on renal biopsy associated with a worse prognosis:

(1) glomerular stages III or IV

(2) presence of focal sclerosis

(3) moderate to marked tubulointerstitial change

(4) absence of mesangial sclerosis


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