Treatment and clinical outcomes of elderly idiopathic membranous nephropathy: A multicenter cohort study in Korea

•Old age is an independent predictor of clinical outcomes and renal outcome risk was increased steeply above age 65 years in idiopathic membranous nephropathy (MN).•The use of angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB) has a beneficial effect on renal outcome and infection in elderly MN patients.•Immunosuppressive therapy did not show superior clinical outcomes compared to conservative therapy in elderly MN patients.•In elderly MN patients, the risk factors for clinical outcome and treatment should be different from those of young age MN patients. Idiopathic membranous nephropathy (MN) is the most common glomerulonephritis in elderly patients showing nephrotic syndrome. However, little is known about its treatment options and outcomes in elderly MN patients at long term follow-up. We retrospectively enrolled patients with biopsy-proven MN between April 1990 and December 2015 from eight tertiary hospitals in Korea. Among them, we excluded patients who had secondary causes of MN and subnephrotic-range proteinuria. We evaluated the presenting features and clinical outcomes and analyzed the all-cause mortality, renal outcomes, infection, and remission with respect to age. During the median follow-up at 77.2 months, 198 younger patients (