Membranous Nephropathy is the most common cause of nephrotic syndrome in adults. The oldest and most widely accepted treatment is alternate monthly steroid and cyclophosphamide, also known as the modified Ponticelli regimen. This regimen requires hospitalisation for three days for administration of intravenous steroid  in the first, which is then followed by oral steroids for the remaining 27 days. This schedule is followed in the first, third, fifth month. In the second, fourth and sixth month patient is given oral cyclophosphamide. This regimen requires  a fair degree of patient understanding and compliance, and also the need for hospitalisation.

There has been no study till date evaluating a completely oral regimen for treatment of membranous nephropathy. An oral regimen where cycplophosphamide and steroid is administered daily for three months, followed by only steroid for the remaining three months, will be easier for the patient to follow. It will not require hospitalisation and can ensure patient compliance. In this regimen, the total cumulative dose of steroid will be lower.  

So our study attempts to evaluate both efficacy and safety of the oral regimen to the already established treatment of alternate cyclical steroid and cyclophosphamide in the treatment of adult nephrotic syndrome patients with membranous nephropathy.