【Abstract】 Objective To investigate the epidemiological features and therapeutic effect and its risk factors of patients with idiopathic membranous nephropathy (IMN). Methods 200 patients with IMN admitted to our hospital from 2013 to 2015 were enrolled into this study with 64 patients received conservative therapy (control group) and 136 patients received immunosuppressive therapy (observation group). Then patients were divided into nonremission group and remission group according to the treatment effect. Furthermore, the baseline data of remission and non remission patients were investigated, including gender, age, hypertension and diabetes. The correlations of their baseline data with efficacy were assessed by singular and multiple factor analysis. Results The average age of the 200 IMN patients was (5754 ± 434) years old. 124 (6200%) were male and 76 (3800%) were female. 24h urinary protein quantitation was (386 ± 034) g and the serum creatinine was (7367 ± 565) μmol / L. 69 cases were stage Ⅰ, 86 cases were stage Ⅱ, 32 cases were stage Ⅲ and 13 cases were stage Ⅳ. Hematuria was found in 122 cases (61%). The total effective rate of treatment in the observation group was significantly higher than that of the control group (6250% vs 8235%), and the difference was statistically significant (P＜005). Univariate analysis showed that the levels of triglyceride of nonremission and remission patients in control group had significant difference (P＜005), and the levels of triglyceride, ALB, total cholesterol and low density cholesterol of nonremission and remission patients in observation group had statistically significant differences (P＜005). Multivariate analysis showed that triglyceride level was an independent risk factor influencing the effect of IMN conservative therapy, and the levels of triglyceride and ALB are independent risk factors of immunosuppressive therapy. Conclusion IMN has more male patients, mainly manifested as hematuria, massive proteinuria and high blood Scr. Immunosuppressive therapy is better than conservative treatment. High triglyceride level and low serum ALB can affect the clinical efficacy.