Membranous nephropathy
Alternative names:
extramembranous glomerulonephritis; glomerulonephritis - membranous; membranous glomerulonephritis; membranous GN
Treatment:
The goal of treatment is to minimize symptoms and slow the progression of the disease. Symptoms should be treated as appropriate. Medications vary. Often, corticosteroids or immunosuppressive medications may be used to attempt to reduce symptoms and progression of the disorder, with variable results. Medications to treat symptoms may include antihypertensive and diuretic medications. Antibiotics may be needed to control infections.
Treatment of high blood cholesterol and triglyceride levels is recommended to reduce the development of atherosclerosis secondary to nephrotic syndrome. Dietary limitation of cholesterol and saturated fats may be of only limited benefit as the high levels of cholesterol and triglyceride seem to be caused by overproduction by the liver rather than excessive intake of fats. Medications to reduce cholesterol and triglycerides may be recommended.
High-protein diets are of debatable value. In many patients, reducing the amount of protein in the diet produces decrease in urine protein. In most cases, a moderate protein diet (1 gram of protein per kilogram of body weight per day) is usually recommended. Sodium in diet (salt) may be restricted to help control edema. Vitamin D may need to be replaced if nephrotic syndrome is chronic and unresponsive to therapy.
Expectations (prognosis):
Remissions and exacerbations may occur with or without therapy. The course of the disorder is highly variable. Spontaneous remission is possible, as is a variable course of remissions (symptom-free periods) and acute symptomatic episodes. 70 to 90% will have some degree of irreversible kidney damage within 2 to 20 years, with about 20% progressing to end-stage renal disease.
Complications:
Calling your health care provider:
Call for an appointment with your health care provider if symptoms indicate membranous nephropathy may be present. Call for an appointment with your health care provider if symptoms worsen or persist, if you experience a decreased urine output or other new symptom develops.
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