Membranous glomerulonephritis medical therapy: Difference between revisions
No edit summary |
Sunny Kumar (talk | contribs) No edit summary |
||
| (One intermediate revision by one other user not shown) | |||
| Line 1: | Line 1: | ||
__NOTOC__ | __NOTOC__ | ||
{{Membranous glomerulonephritis}} | {{Membranous glomerulonephritis}} | ||
{{CMG}}; {{AE}} {{SAH}} | {{CMG}}; {{AE}} {{SAH}} {{Pervaiz Laghari}} | ||
==Overview== | ==Overview== | ||
| Line 36: | Line 37: | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
[[Category: Nephrology]] | [[Category:Nephrology]] | ||
[[Category: Up-to-date]] | [[Category:Up-to-date]] | ||
Latest revision as of 06:44, 21 October 2020
|
Membranous glomerulonephritis Microchapters |
|
Differentiating Membranous glomerulonephritis from other Diseases |
|---|
|
Diagnosis |
|
Treatment |
|
Case Studies |
|
Membranous glomerulonephritis medical therapy On the Web |
|
American Roentgen Ray Society Images of Membranous glomerulonephritis medical therapy |
|
Directions to Hospitals Treating Membranous glomerulonephritis |
|
Risk calculators and risk factors for Membranous glomerulonephritis medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Ahsan Hussain, M.D.[2] Pervaiz Laghari, MD[3]
Overview
Pharmacologic medical therapy is recommended among patients who has infectious, autoimmune causes of membranous glomerulonephritis. The drugs like prednisone and cyclophospamide are recomended for the treatment of autoimmune cause of membranous glomerulonephritis. Drug like Angiotensin receptor inhibitior (ACEi) is recomended for managment of hypertension.
Medical Therapy
Following is the treatment of membranous glomerulonephritis.[1][2][3][4]
- Pharmacologic medical therapy is recommended among patients who has infectious, autoimmune causes of membranous glomerulonephritis.
- First-line therapy for MN is immunosupressive therapy. Patients with autoimmune are treated with immunosuppressive therapy.
- Other pharmacologic medical therapies for membranous glomerulonephritis is treatment of proteinuria which include antihypertensive therapy, anticoagulation therapy, anti-lipid therapy.
1. Patients with autoimmune etiology
1.1 Immunosuppressive therapy:
- Preferred regimen (1): Prednisone 0.5 mg/kg per day with cyclophosphamide IV for 3-5 months
- Preferred regimen (2): Methylprednisolone 0.4 mg/kg per day given with cyclophosphamide 2.0 to 2.5 mg/kg per day given IV for 2, 4, and 6 months
- Preferred regimen (3): Tacrolimus 0.05 mg/kg per day for PO for 12 months with a six-month taper
- Preferred regimen (4): Rituximab 3.5g/day IV for 6-12 months
2. Treatment for proteinuria:[5]
2.1 Antihypertensive therapy
- Preferred regimen (1) Losartan PO for 50 mg q daily (100mg per day)
2.2 Anticoalgulation tharapy
- Low molecular weight or unfractionated heparin, followed by PO warfarin
2.3 Anti-lipid therapy
2.3.1 Life-style modification
- Decrease salt intake
- Weight loss
2.3.2 Statins
- Atorvastatin PO 10mg q daily
References
- ↑ Bomback AS, Fervenza FC (2018). "Membranous Nephropathy: Approaches to Treatment". Am J Nephrol. 47 Suppl 1: 30–42. doi:10.1159/000481635. PMID 29852477.
- ↑ Waldman M, Austin HA (2012). "Treatment of idiopathic membranous nephropathy". J Am Soc Nephrol. 23 (10): 1617–30. doi:10.1681/ASN.2012010058. PMC 3458460. PMID 22859855.
- ↑ Wasserstein AG (April 1997). "Membranous glomerulonephritis". J. Am. Soc. Nephrol. 8 (4): 664–74. PMID 10495797.
- ↑ Ozsoy RC, Koopman MG, Kastelein JJ, Arisz L (April 2005). "The acute effect of atorvastatin on proteinuria in patients with chronic glomerulonephritis". Clin. Nephrol. 63 (4): 245–9. PMID 15847250.
- ↑ Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Dennison Himmelfarb C, DePalma SM, Gidding S, Jamerson KA, Jones DW, MacLaughlin EJ, Muntner P, Ovbiagele B, Smith SC, Spencer CC, Stafford RS, Taler SJ, Thomas RJ, Williams KA, Williamson JD, Wright JT (June 2018). "2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines". Hypertension. 71 (6): e13–e115. doi:10.1161/HYP.0000000000000065. PMID 29133356.