Abstract: Objective To investigate the feasibility of serum and urine angiopoietin-like 4(Angptl4) for evaluating and predicting efficacy for membranous nephropathy. Methods A total of 37 patients with primary membranous nephropathy was divided into two groups, receiving methylprednisolone combined with cyclophosphamide and methylprednisolone combined with cyclosporine A respectively for six months. All the patients were detected for serum and urine Angptl4 levels,total urine proteinand biochemical indicators such as plasma albumin and alanine aminotransferaseat various time points before treatment and within 6 months after treatment. Statistics and Mapping were done with software SPSS 24.0 and Graphpad Prism 5.0. Results (1) The effective rate sin the two groups was comparable. (2) Pearson linear correlation analysis showed that total urine protein and urine Angptl4 were linearly correlated.(3)The changes of total urine protein and urine Angptl4 with time were statistically significant,and the change of urine Angptl4 in the early stage of treatment was more obvious. (4) There were no significant changes in plasma Angptl4 levels. Conclusions Compared with total urine protein,urine Angptl4 can earlier evaluate and predict efficacy for membranous nephropathy.