Tacrolimus Monotherapy for Idiopathic Membranous Nephropathy

Inclusion Criteria

• •1. Age: 18 - 80 years;
• •2. Those whose clinical manifestation and renal biopsy pathologic diagnosis are IMN (Stages I-IV) with secondary membranous nephropathy excluded;
• •3. Those who meet any of the following high-risk IMN standards:
• •* Urinary protein\>8g/24h
• •* Serum albumin\<25g/l
• •* Serum PLA2R levels are 5 times higher than normal
• •* eGFR decline rate after confirmed IMN within 6-12 months is ≥30%
• •* Patients with serious complications: pulmonary embolism, lower extremity static Vein thrombosis/embolism, acute renal injury, etc.
• •4. Those without reaching the above high-risk IMN standard, but their course of disease is \>6 months without spontaneous remission,and still present nephrotic syndrome;
• •5. Patients who have signed the informed consent forms.
• •4. Those who need to take medications prohibited by the trail;
• •5. Those with poor compliance or stopping the drug for over 2 weeks;
• •6. Those with uncontrollable infection;
• •7. Those whit elevated blood glucose during the treatment, which is still difficult to control after routine treatment by endocrinologists;
• •8. In the TAC group, the eGFR decreased by \>30%, the TAC dose was halved. And the drug concentration and renal function were reviewed after 2 weeks. If the eGFR decreased by \<30%, it will continue to be used; if the eGFR still decreased by \>30%, the TAC dose continues to halve, or give a minimum dose of 0.5mg / d. And the drug concentration and renal function were reviewed after 2 weeks. If the eGFR decreased by \<30%, TAC will continue to be used, otherwise stop the drug;
• •9. Those whose ALT, AST or bilirubin rises to more than 2 times the upper limit of normal value after treatment, and continues to increase for 2 weeks; those whose ALT, AST or bilirubin rises to more than 2 times the upper limit of normal value after 2 weeks of treatment with liver protection, the drug will be discontinued. If it cannot be recovered after 2 weeks, the patient will withdraw;
• •10. Those with other unexplained severe comorbidities;
• •11. Those with pregnancy during treatment;
• •12. For security reasons, the research sponsor proposed to stop the study;