IgM mesangial proliferative glomerulonephritis

Alternative names:

glomerulonephritis - mesangial proliferative

Treatment:

Treatment goals are to relieve symptoms and prevent of complications. The disorder is usually chronic, requiring prolonged treatment.

Corticosteroid, immunosuppressive, antihypertensive, and diuretic medications may be given in an attempt to control symptoms and retard progression of the disorder. Although the presence of antibodies indicates there is some type of immune response causing the disorder, suppression of the immune system with corticosteroids and immunosuppressives may not reduce symptoms in all cases.

Treatment of high blood cholesterol and triglyceride levels may be recommended to reduce the development of atherosclerosis. Dietary limitation of cholesterol and saturated fats may be of only limited benefit because high levels of cholesterol and triglyceride associated with this disorder appear 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 diet produces a decrease in urine protein. A moderate-protein diet (1 gram/kilogram of body weight/day) is usually recommended. In cases of renal failure, a low-protein diet is recommended to reduce the accumulation of dangerous nitrogen containing wastes (a by-product of protein metabolism).

Sodium (salt) and fluids may be restricted to help control swelling. Vitamin D may need to be replaced if nephrotic syndrome develops that is unresponsive to therapy.

Expectations (prognosis):

The outcome varies. The disorder may be acute and short-term, or chronic and unresponsive to therapy. Complications can affect the outcome.

Complications:

• atherosclerosis and related heart diseases
• renal vein thrombosis
• acute renal failure
• chronic renal failure
• infections, including pneumococcal pneumonia
• malnutrition
• fluid overload, congestive heart failure, pulmonary edema

Calling your health care provider:

Call your health care provider if symptoms indicate mesangial proliferative glomerulonephritis may be present.

Call your health care provider if decreased urine output or other new symptoms develop.