To evaluate the actual use of different treatments for idiopathic membranous glomerulonephritis in Italy, we selected all patients who were registered with a diagnosis of this disease at the Italian Renal Biopsy Registry between 2001 and 2005. It was surprising that single-steroid treatment without immunosuppressive drugs was preferred in 34.4% of patients to steroids associated with immunosuppressive drugs (the Ponticelli regimen), used only in 26.6%. Ace inhibitors and angiotensin II receptor blockers were given as the therapy of choice in 23.4% of cases, as an adjunct to steroids in 41%, and to steroids/ immunosuppressants in 52%. Ace inhibitors and angiotensin II receptor blockers were thus used most in the treatment of idiopathic membranous nephropathy and it would therefore be interesting to assess the role of antiproteinuric agents in greater depth in future studies.