Hi samb2004,
Briefly, Membranous Glomerulonephritis is an inflammation of the
glomeruli, the tiny units within the kidneys where all the filtering
of the blood takes place. Any malfunctioning of the glomeruli will
interfere with the proper filtering of the blood and can cause leakage
of protein and red blood cells into the urine. The disease can be
either acute or chronic, and can be caused by a variety of ailments -
often, curing the underlying cause will also cure the inflammation. If
the condition becomes chronic, treatment consists of stopping the
progression of the disease (limit salt intake, treat hypertension,
edema, etc). The worst case scenario is that it will lead to ESRD
(end-stage renal disease) requiring dialysis and/or a kidney
transplant. However, the sooner diagnosis is made the better, and if
your son has received early treatment, his prognosis is very good.
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DEFINITION:
"Glomerulonephritis (gloh-MAIR-yoo-loh-neh-FRY-tis) describes the
inflammation of the membrane tissue in the kidney that serves as a
filter, separating wastes and extra fluid from the blood."
http://kidney.niddk.nih.gov/kudiseases/pubs/glomerular/
"Membranous nephropathy is a kidney disorder resulting in disruption
of kidney function because of inflammation of the glomerulus and
changes in the glomerular basement membrane."
http://www.nlm.nih.gov/medlineplus/ency/article/000472.htm
"A disease of the glomerulus manifested clinically by proteinuria, and
sometimes by other features of the nephrotic syndrome. It is
histologically characterized by deposits in the glomerular capillary
wall between the epithelial cell and the basement membrane and a
thickening of the membrane. Also characteristic are outward
projections of the membrane between the epithelial deposits in the
form of "spikes". There is some agreement that the deposits are
antigen-antibody complexes."
http://www.websters-online-dictionary.org/definition/english/Gl/Glomerulonephritis%2C+Membranous.html
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SYMPTOMS
*edema (eh-DEE-muh): Swelling caused by the accumulation of fluid in
cells and tissues. In kidney failure, fluid may collect in the feet,
hands, abdomen, or face.
* hematuria (HEE-muh-TOOR-ee-uh): Blood in the urine. Blood may turn
the urine pink or cola-colored.
* hypoproteinemia (HY-po-PRO-teen-EE-mee-uh): Reduced levels of
protein in the blood.
* proteinuria (PRO-teen-YOOR-ee-uh): Large amounts of protein in the urine.
* uremia (yoo-REE-mee-uh): Accumulation of urea and other wastes in
the blood. These wastes, which become toxic in large amounts, are
normally eliminated through urination."
http://kidney.niddk.nih.gov/kudiseases/pubs/glomerular/
* Edema (swelling) in any area of the body, may be generalized
* Foamy appearance of urine
* Weight gain (from fluid retention)
* Poor appetite
* Urination, excessive at night
* Blood pressure, high
http://www.nlm.nih.gov/medlineplus/ency/article/000472.htm
Note: Symptoms vary and no symptoms may be present in many cases.
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TREATMENTS:
Medical Care is determined by the underlying cause, but some common treatments are:
* A low-salt diet is key to reducing anasarca. Protein restrictions
may or may not be useful in reducing the rate of progression of
chronic renal failure.
* Diuretics help control edema...
* NSAIDs help to decrease the proteinuria...
* ACE inhibitors decrease proteinuria and control hypertension...
* Hepatic 3-methylglutaryl coenzyme A reductase inhibitors help treat
hypercholesterolemia.
* Routine anticoagulation is controversial...
* In hepatitis-associated membranous nephropathy, antivirals may be useful.
* Treat hypertension aggressively.
http://www.emedicine.com/med/topic885.htm
"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.
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 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."
http://www.nlm.nih.gov/medlineplus/ency/article/000472.htm
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COMPLICATIONS:
* Nephrotic syndrome
* Chronic renal failure
* End-stage renal disease
* Renal vein thrombosis
* Pulmonary embolism
http://www.nlm.nih.gov/medlineplus/ency/article/000472.htm
* Most complications are associated with heavy proteinuria.
* Serositis is a possible complication.
* Hypovolemia, with the possibility of acute renal failure, may occur
in patients who are overdiuresed. Hypovolemia exacerbates the adverse
renal effects of ACE inhibitors, ARBs, and NSAIDs.
* Increased incidence of infection may be present, even in patients
not receiving immunosuppressives.
* Hyperfibrinogenemia and erythrocytosis may lead to a hypercoagulable
state, particularly renal vein thrombosis. Nephrotic syndrome may also
result in loss of antithrombin III.
* Lethargy and tiredness are complications.
* An increased incidence of ischemic heart disease has not been proven.
http://www.emedicine.com/med/topic885.htm
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PROGNOSIS:
"The outcome depends on the renal function at the time of diagnosis
and the amount of proteinuria, ranging from remission without
medication to ESRD."
http://www.emedicine.com/med/topic885.htm
"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. Some 70% to 90% of patients will have
some degree of irreversible kidney damage within 2 to 20 years, with
about 20% progressing to end-stage renal disease."
http://www.nlm.nih.gov/medlineplus/ency/article/000472.htm
The Nephrotic Syndrome
* The nephrotic syndrome is a condition marked by very high levels of
protein in the urine; low levels of protein in the blood; swelling,
especially around the eyes, feet, and hands; and high cholesterol.
* The nephrotic syndrome is a set of symptoms, not a disease in
itself. It can occur with many diseases, so prevention relies on
controlling the diseases that cause it.
* Treatment of the nephrotic syndrome focuses on identifying and
treating the underlying cause, if possible, and reducing high
cholesterol, blood pressure, and protein in the urine through diet,
medication, or both.
* The nephrotic syndrome may go away once the underlying cause, if
known, is treated. However, often a kidney disease is the underlying
cause and cannot be cured. In these cases, the kidneys may gradually
lose their ability to filter wastes and excess water from the blood.
If kidney failure occurs, the patient will need to be on dialysis or
have a kidney transplant.
http://kidney.niddk.nih.gov/kudiseases/pubs/glomerular/
Additional Link:
Glomerulonephritis Hub: Links:
http://www.healthubs.com/glomerulonephritis/
I hope I've been able to sort this out for you a bit and managed to
reduce your stress at the same time. If you need further assistance,
please post a clarification request before closing/rating my answer
and I'll be happy to respond.
Thank you,
hummer
Google Search Terms Used
Membranous glomerulonephritis
glomerular inflammation
glomerulus inflammation |
