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Membranous nephropathy

• Overview
• Symptoms
• Treatment
• Prevention

Alternative Names:

Membranous glomerulonephritis; Membranous GN; Extramembranous glomerulonephritis; Glomerulonephritis - membranous

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, 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.

Affected individuals are at increased risk for thrombotic (clotting) events involving the lungs (pulmonary embolisms) and legs (deep venous thromboses, often referred to as DVTs). Those affected are therefore occasionally prescribed warfarin or other blood thinners to prevent these complications.

High-protein diets are of debatable value. In many patients, reducing the amount of protein in the diet produces decrease in protein in the urine. 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 did not respond to therapy.

Expectations (prognosis):

The condition may go away, or may get worse, with or without therapy. The course of the disorder is highly variable. Spontaneous remission (when the disease goes away) is possible, as is a variable course of remissions (symptom-free periods) and acute symptomatic episodes. Some 70-90% of patients will have some degree of irreversible kidney damage within 2-20 years, with about 20% progressing to end-stage renal disease

Complications:

• Nephrotic syndrome
• Chronic renal failure
• End-stage renal disease
• Renal vein thrombosis
• Pulmonary embolism

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.

• Review Date: 9/13/2005
• Reviewed By: Robert Mushnick, M.D., Clinical Assistant Professor, SUNY Downstate Health Center, Brooklyn, NY. Review provided by VeriMed Healthcare Network.

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