Primary membranous nephropathy (PMN) is a rare autoimmune kidney disease where the immune system mistakenly attacks the kidney filters. This damage can cause protein to leak into the urine and lead to symptoms like swelling, foamy urine, and fatigue.
Bloody or foamy urine
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Edema (swelling in hands, feet, legs, ankles, abdominal area, or face)
Fatigue
High blood pressure
Primary membranous nephropathy happens when the immune system mistakenly attacks the kidney filters. This is the most common type and is usually linked to antibodies such as anti-PLA2R.
Secondary Membranous Nephropathy
Secondary membranous nephropathy is caused by another underlying condition, such as lupus, infections, certain cancers, or some medicines.
Understanding Symptoms: Many people first notice signs like foamy urine, swelling in the legs or around the eyes, or feeling more tired than usual. These symptoms can be easy to miss, so it is common for PMN to go undiagnosed at first.
Seeing a Healthcare Provider: A doctor may order tests if they see protein in the urine or changes in kidney function. This often starts with simple blood and urine tests.
Blood Tests: Blood tests can help measure kidney function and look for antibodies linked to PMN, such as anti-PLA2R.
Urine Tests: Urine samples show how much protein is leaking into the urine. This helps doctors understand how the kidneys are working.
Kidney Biopsy: In many cases, a kidney biopsy is used to confirm the diagnosis. A small sample of kidney tissue is looked at under a microscope to check for the changes seen in PMN.
Monitoring Over Time: Once diagnosed, people with PMN are followed with regular blood and urine tests to watch protein levels, kidney function, and symptoms.
Blood Pressure Medications: Medicines like ACE inhibitors or ARBs can help lower protein in the urine and reduce stress on the kidneys.
Diuretics: These “water pills” help the body get rid of extra fluid and can reduce swelling in the legs, feet, and around the eyes.
Statins: Some people with PMN develop high cholesterol, and statins can help manage those levels.
Immune-Modifying Treatments: Medications such as rituximab or other immune-suppressing drugs are sometimes used to lower the immune system’s attack on the kidneys.
Diet and Lifestyle Changes: Limiting salt, eating a balanced diet, staying active, and managing blood pressure can support kidney health.
Monitoring and Regular Testing: Many people with PMN are closely followed by their doctors with blood and urine tests to track kidney function and protein levels.
Ongoing Protein Loss: High levels of protein in the urine can weaken the body and lead to long-term kidney strain.
Fluid Retention and Swelling: As kidney function changes, the body may hold on to extra fluid, causing swelling in the legs, feet, or around the eyes.
High Blood Pressure: Kidney damage can make it harder for the body to control blood pressure, which can worsen kidney function over time.
High Cholesterol Levels: Protein loss can cause the liver to make more cholesterol, which may increase heart-related risks.
Risk of Blood Clots: People with PMN may be at higher risk of developing blood clots due to changes in protein levels.
Progression to Kidney Damage: If PMN continues to worsen, the kidneys may lose their ability to filter blood well. In some cases, this can lead to chronic kidney disease or, rarely, kidney failure.
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