Membranous nephropathy corticosteroids

The treatment of secondary membranous nephropathy is directed at removing the underlying cause. For instance, membranous nephropathy secondary to syphilis can be treated with peni-cUfin. a-Interferon is beneficial for hepatitis B-induced membranous nephropathy. Corticosteroids should be avoided because they may induce transient viral replication. ... 

The hypercoagulable state of nephrotic subjects is further worsened with immobilization, hemoconcentration in patients with decreased intravascular volume (usually due to diuretic therapy), and corticosteroid therapy. Prophylactic anticoagulant therapy should be administered to high-risk patients, for example, patients with membranous nephropathy with nephrotic proteinuria and serum albumin level below 20 g/L. 

Nephrotic syndrome. Patients with minimal change disease respond well to daily or alternate day therapy. With a total of prednisolone 60 mg/d, 90% of those who will lose their proteinuria will have done so within 4-6 weeks, and the dose is tapered off over 3-4 months. Longer courses only induce adverse effects. Relapses are common (50%) and it is then necessary to find a minimum dose of steroid that will keep the patient well. If a steroid is for any reason undesirable, cyclophosphamide or chlorambucil may be substituted. Membranous nephropathy may respond to high dose corticosteroid with or without chlorambucil. 

Lai KN, Tam JS, Lin HJ, et al. The therapeutic dilenuna of the usage of corticosteroid in patients with membranous nephropathy and persistent hepatitis B virus surface antigenaemia. Nephron 1990 54 12-17. 

---