Renal biopsy is an important diagnostic procedure in nephrology useful for therapeutic decision making as well as for estimating prognosis. Definite pathological diagnosis was reached in 752 cases(377 males and 375 females) of the patients who underwent renal biopsy at the Keio University Hospital during the past 35 years, between 1969 and 2003, by light and electron microscopy as well as by immunotluorescence study. There were 5 i 9 cases with primary glomerular diseases and 221 wlth various secondary renal diseases. Twenty-two of 33(17males and 16females)membranous ephropathy (MN) patients , includins 20 who presented with nephrotic syndrome, were treated with prednisolone as steroid therapy . After one year of follow up, urinary protein decreased to less than l gram per day in 54 .5%of those treated with prednisolone, while the comparable(figure without steroid 1herapy was 36.4%), The amount of urinary protein at the end of 2 years of follow-up correlated better with the urinary protein after l month of treatment than that of the pretreatment stage, suggesting that short term effect of steroid is an useful predictor of the long term prognosis in MN. Analysis of our clinical data revealed that age above 55, urinary protein greater than 5 grams/day, elevated serum creatinine concentration, and hypertension suggest unfavorable outcome」t is concluded that treatment with steroid aiming at early reduction in urinary prolein IS indicated, as a rule, in patients with MN.

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