Lerner GB, Virmani S, Henderson JM, et al. - By performing this review, researchers analyzed the current understanding of the development as well as time-course of alterations in serum aPLA2R (autoantibodies to phospholipase A2 receptor) concentrations, proteinuria and histological findings that underlie the pathophysiology of primary membranous nephropathy, which represents a leading cause of adult nephrotic syndrome. For managing this disease, clinical parameters such as proteinuria, as well as concentrations of circulating aPLA2R and the results of immunofluorescent staining for aPLA2R on renal biopsy, all are nowadays used as guiding tools. The link between immunologic and clinical disease course is consistent, but not necessarily intuitive. Additionally, only a single snapshot of disease is afforded by renal biopsy which is required to be interpreted in light of altering clinical as well as serological findings. For staging, treatment, and management of this disease, it is important to acquire a clear understanding of these dynamic parameters.