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Membranous nephropathy is a common cause of nephrotic syndrome in adults. Many patients can be observed without initiating immunosuppressive treatment; however, patients at substantial risk for progressive disease (according to serial measurements of urine protein and glomerular filtration rate) typically are treated with cyclophosphamide plus glucocorticoid or with a calcineurin inhibitor (e.g., cyclosporine). In this industry-funded randomized trial, 130 adults with membranous nephropathy who were at moderate-to-high risk for progression received either cyclosporine or the anti-CD20 monoclonal antibody rituximab. At enrollment, median urinary protein was 8.9 g per 24 hours, median serum creatinine was 1.3 mg/dL, and median serum albumin w…