Membranous glomerulonephritis is a disease characterized by impaired renal function. What symptoms are accompanied by the disease and what measures should be taken?
Membranous glomerulonephritis is a serious kidney disease characterized by the appearance of diffuse protein deposits. They are localized mainly along the wall of glomerular capillaries.
The sediments contain IgG immunoglobulins. At first glance, pathological changes resemble focal sclerosis. The main difference is the uniform arrangement of affected areas.
The disease accounts for 30-40% of the nephrotic syndrome. These disorders occur mainly in adults. Only in 80% is diagnosed with HC, and in others, proteinuria.
By origin, diffuse membranous glomerulonephritis occurs in several forms. First of all, it is necessary to distinguish the primary, the so-called idiopathic. It develops, as a rule, independently. There is no need for this.
Secondary form of the disease occurs due to abnormalities occurring in the body. The reason for this is unfavorable factors.
It is also possible to isolate forms of membranous glomerulonephritis:
- Acute. It develops due to infectious processes in the body, which have streptococcal etiology. Symptomatology of the disease in this case is limited and expressed quite clearly.
- Chronic. Characterized by a latent recurrent course. With this form of the disease, sclerotic disorders and changes in the area of the kidneys with fibroplastic characteristics are noted.
Membrane-type glomerulonephritis leads to the development of NS( nephrotic syndrome).This condition is accompanied by the appearance of protein in the urine and edema in the face and lower extremities.
Signs and symptoms
The disease is characterized by the defeat of both kidneys. In this case, there is a violation of the functions of the urinary organs. This is fraught with the development of such consequences as the penetration of the Christmas tree and blood cells into the urine, which reduces the number of substances necessary for normal life activity in the human body.
Membranous glomerulonephritis has an inflammatory character, which is characterized by an infectious and allergic nature. The development of the pathological process can be associated with tumors of malignant type and hepatitis B.
The disease develops as follows:
- For the primary stage of pathological changes in the kidney area, the appearance of sufficiently dense inclusions in the epithelium region is characteristic. In this case, the diagnosis is complicated, because the changes from the membrane are not visible.
- In the second stage of the disease, neural thickenings appear in the region of the membrane. In this case, it is possible to detect outgrowths of a pointed type located between the deposits.
- The third stage is the development of immune deposits, which are located in the region of the membrane. Its appearance due to thickening is like Swiss cheese. The adolescents unite in the region of epithelial clusters.
- In the fourth stage, the development of so-called fibrosis is noted. These changes are pronounced, so the diagnosis is not difficult.
For each stage of development of the pathological process, there are specific signs. At the very beginning of the pathological process, the indices of blood pressure do not change, sediment in the biological fluid released by the kidneys and glomerular filtration is also not observed.
As protein progresses, the protein appears in the urine, and in the blood plasma the concentration of immunoglobulin decreases. This stage of development is accompanied by a sharp set of weight and the appearance of shortness of breath. At this stage, as a rule, blood cells can be determined in the urine, and the volume of fluid that is released by the kidneys decreases sharply.
In some cases, the disease is hidden, not revealing itself at the very beginning of development. In this case, the changes that occur in the body are often mistaken for other pathologies. Kidney dysfunction is noted. Deterioration occurs slowly enough, so primary manifestations are often overlooked.
The disease develops against the background of penetration of the genitourinary system of bacteria and viruses. It is not excluded the occurrence of pathological changes in the kidney area in the presence of malignant tumors in the body. Perhaps the development of the disease in persons who take drugs.
Streptococci may be the cause of glomerulonephritis progression. Infectious damage to the internal organs develops in 2-3 weeks after the infection in the human body.
With glomerulonephritis of membranous type, patients are sent to a specialist too late. As a rule, this occurs when there is pronounced puffiness. In this case, there is proteinuria, which is characterized by nephrotic changes. It is often enough that the arterial form of hypertension joins it.
At the reception the doctor collects an anamnesis of the disease and diagnoses only after receiving the results of laboratory and instrumental studies. In some cases, proteinuria is detected. At the same time, the rate of renal filtration decreases. The remaining indicators may remain normal.
Such a study as electron microscopy makes it possible to determine the state of the immune complexes. As a rule, with pathology, they have the appearance of fairly dense inclusions. The membrane ons can appear both in the early and late stages of the disease. This leads to the fact that the epithelium thickens. It should be noted that there is no exudation and necrosis.
Treatment of pathological changes in the kidney area, first of all, is aimed at eliminating the causes of their occurrence. If there are no signs of the disease, then medicamental measures are not taken even if proteinuria is present. In this case, the patient needs to carry out laboratory tests from time to time.
If the place has a nephrotic range, but the patient does not complain about pathological changes, then medication is prescribed. Medicines are necessary only in the presence of edema. In this case, the patient is recommended to be supervised by specialists. Most of these patients completely remission after 3 or 4 years.
The appointment of immunosuppressants is necessary only if the nephrotic syndrome develops. Drugs of this type are necessary for those people who are prone to progressing the disease.
Most doctors recommend treatment according to the following scheme:
- Assign a drug such as Methylprednisolone. Recommended dosage: 1 g intravenously. The course of treatment is at least 3 and not more than 5 days.
- Prescribe Prednisolone 0.5 mg per kg of body weight orally once a day. The drug is recommended to take within 27 days.
- Assign a drug such as Chlorambucil 0.2 mg per kg of body weight orally once a day. Therapy lasts for a month.
Pathological disorders in the genitourinary system do not cause pain. That is why the risks of developing unwanted reactions to medications used may exceed the therapeutic effect.
Treatment is performed with the help of the above drugs for six months. Medicines alternate. That allows you to achieve a pronounced and lasting result. Drug medications should be prescribed strictly individually. Particular attention should be given to dosage. Specialists should take into account the risks of developing infectious complications in elderly patients.
Patients who can not be prescribed cytotoxic drugs are recommended to take a medication such as Ciclosporin in the following dosage: 4-6 mg / kg per day. Arterial hypertension requires the use of blockers and ACE inhibitors. Even if there is no change in the blood pressure, these remedies are still useful, since they eliminate the causes of development and the symptoms of proteinuria. Necessarily, diuretics and coagulants are prescribed as prophylaxis.
Do I need a diet?
In order to increase the effectiveness of the treatment and eliminate the symptoms of the disease, the patient needs to adjust the nutrition. Diets table number 7 must be adhered to with 3-4 from the beginning of the development of manifestations of the pathological process in the body. Within three days, it is recommended to hold contrasting days.
The goal of dietary nutrition is to normalize the functioning of the kidneys in the presence of severe inflammation and increase the effectiveness of the treatment used. Achieving a lasting positive result is achieved by normalizing metabolic processes, improving the excretion of urine and excluding allergenic agents.
On the video about the causes, symptoms and treatment of membranous glomerulonephritis: