Membranous nephropathy
Alternate Names : Membranous glomerulonephritis, Membranous GN, Extramembranous glomerulonephritis, Glomerulonephritis - membranous, MGN
Treatment
The goal of treatment is to reduce symptoms and slow the progression of the disease. Controlling blood pressure is the most important measure to delay kidney damage. The goal is to keep blood pressure at or below 130/80 mmHg. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are the medicines most often used.
Corticosteroids and other drugs that suppress or quiet the immune system may be used. High blood cholesterol and triglyceride levels should be treated to reduce the risk of atherosclerosis. However, a low-fat, low-cholesterol diet is usually not as helpful for people with membranous nephropathy. Medications to reduce cholesterol and triglycerides may be recommended, most commonly statins. A low salt diet may help with swelling in the hands and legs. Water pills or diuretics may also help with this problem. Low protein diets may or may not be helpful. A moderate-protein diet (1 gram of protein per kilogram of body weight per day) may be suggested. Vitamin D may need to be replaced if nephrotic syndrome is chronic and does not respond to therapy. This disease increases the risk for blood clots in the lungs and legs.Patients are occasionally prescribed blood thinners to prevent these complications.
Prognosis (Expectations)
The outlook varies. There may be symptom-free periods and acute flare ups. In some cases, the condition may go away with or without therapy. The majority of patients will have some degree of irreversible kidney damage within 2-20 years. About 20% of those will progress 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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