This article (http://seattleweb.intel-research.net/people/lamarca/pubs/pap...) coming out of Intel argues that it is also difficult to implement more sophisticated structures on top of a distributed key/value. The author's main point is that a few specialized applications can and have been built on a plain distributed key/value store, but most applications have ended up having to customize the key/value store's internals to achieve their functional or performance goals.
From the little bit I have read about Membase it looks well positioned to bring simple distributed key/values stores to the next level and back into the lime light.