Membranous nephropathy is a kidney disorder that leads to changes and inflammation of the structures inside the kidney that help filter wastes and fluids. The inflammation may lead to problems with kidney function.
Membranous glomerulonephritis; Membranous GN; Extramembranous glomerulonephritis; Glomerulonephritis – membranous; MGN
Membranous nephropathy is caused by the thickening of part of the glomerular basement membrane. The glomerular basement membrane is a part of the kidneys that helps filter waste and extra fluid from the blood. The exact reason for this thickening is not known.
The thicker glomerular membrane does not work normally. Large amounts of protein are lost in the urine as a result.
This condition is one of the most common causes of
The following increase your risk for this condition:
Cancers, especially lung and colon cancer
Exposure to toxins, including gold and
hepatitis B, malaria, syphilis, and endocarditis
Medicines, including penicillamine, trimethadione, and skin-lightening creams
Systemic lupus erythematosus, rheumatoid arthritis, Graves’ disease, and other autoimmune disorders
The disorder occurs in about 2 out of every 10,000 people. It may occur at any age, but is more common after age 40.
Symptoms often begin slowly over time, and may include:
Edema(swelling) in any area of the body
- Foamy appearance of urine (due to large amounts of protein)
Poor appetite Urination, excessive at night Weight gain
Exams and Tests
A physical exam may show swelling (edema).
Other tests may be done to see how well the kidneys are working and how the body is adapting to the kidney problem. These include:
Albumin– blood and urine Blood urea nitrogen(BUN) Creatinine – blood Creatinine clearance
- Lipid panel
- Protein – blood and urine
The following tests can help determine the cause of membranous nephropathy:
- Antinuclear antibodies test
- Anti-double-strand DNA, if the antinuclear antibodies test is positive
- Blood tests to check for hepatitis B, hepatitis C, and syphilis
- Complement levels
The goal of treatment is to reduce symptoms and slow the progression of the disease.
Controlling blood pressure is the most important way 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 to lower blood pressure.
Corticosteroids and other drugs that suppress the immune system may be used.
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 be helpful. A moderate-protein diet (1 gram of protein per kilogram of body weight per day) may be suggested.
This disease increases the risk for blood clots in the lungs and legs. Patients are occasionally prescribed blood thinners to prevent these complications.
Screening for age-appropriate malignancies is warranted, if not already done.
The outlook varies, depending on the amount of protein loss. Patients may have symptom-free periods and occasional flare-ups. In some cases, the condition may go away, either with or without therapy.
Most patients will have some
Chronic renal failure Deep venous thrombosis End-stage renal disease Nephrotic syndrome Pulmonary embolism Renal vein thrombosis
When to Contact a Medical Professional
Call for an appointment with your health care provider if:
You have symptoms of membranous nephropathy
Your symptoms get worse or don’t go away
You develop new symptoms
decreased urine output
Quickly treating disorders and avoiding substances that can cause membranous nephropathy may reduce your risk.