Membranoproliferative glomerulonephritis natural history, complications and prognosis: Difference between revisions
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== Complication == | == Complication == | ||
the most common complications in patients who have MPGN are included: | the most common complications in patients who have MPGN are included: | ||
* End-stage renal disease (ESRD) | * End-stage renal disease (ESRD) | ||
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* Anemia due to iron deficiency | * Anemia due to iron deficiency | ||
* Hypocalcemia due to hyperparathyroidism secondary to vitamin D deficiency | * Hypocalcemia due to hyperparathyroidism secondary to vitamin D deficiency | ||
== Prognosis == | |||
Factors that worsen the prognosis of MPGN are included:<ref>{{Cite journal|last=Janette C.Cansick, Rachel lennon|first=|date=2004|title=prognosis, treatment and outcome of childhood mesangiocapillary|url=|journal=Nephrology Dialysis Transplantation|volume=|pages=|via=}}</ref> | |||
* Hypertension at presentation | |||
* Elderly individuals | |||
* Low GFR at 1st year of presentation | |||
Patients with MPGN type 1 and nephrotic syndrome have the chance of 50% to develop end-stage renal disease (ESRD) within 10 years and 90% in 20 years. Type II MPGN is some how more aggressive and 50% of patients eventuate in ESRD after 10 years of diagnosis.<ref>{{Cite journal|last=Michelle M. O’Shaughnessy, Maria E. Montez-Rath, Richard A. Lafayette and Wolfgang C. Winkelmayer|first=|date=2015|title=Differences in initial treatment modality for end-stage renal disease among glomerulonephritis subtypes in the USA|url=|journal=Nephrology Dialysis Transplantation|volume=|pages=|via=}}</ref><ref>{{Cite journal|last=Sanjeev Sethi, M.D., Ph.D., and Fernando C. Fervenza, M.D., Ph.D.|first=|date=2012|title=Membranoproliferative Glomerulonephritis — A New Look at an Old Entity|url=|journal=The new england journal of medicine|volume=|pages=|via=}}</ref> | |||
==References== | ==References== | ||
Revision as of 15:11, 23 July 2018
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Overview
Natural history
The natural history of Membranoproliferative glomerulonephritis (MPGN) is characterised by severity of clinical features which autonomously fluctuate, with very few cases of complete remission. Acute presentation and a slower reduction in renal function have seen more in children than adults. ESRD have been occurred among approximately 40% of patients within 10 years of diagnosis. Features suggestive of an adverse outcome include the nephrotic syndrome, renal dysfunction at onset, and persistent hypertension. Type II MPGN is associated with a worse prognosis, as is the presence of chronic interstitial damage on renal biopsy. In 20 - 30% of type I and 80 - 90 % type II MPGN, Membranoproliferative glomerulonephritis may recur.
Complication
the most common complications in patients who have MPGN are included:
- End-stage renal disease (ESRD)
- Edema
- Periorbital
- Dependent edema
- Hypertension
- Infection with encapsulated bacteria
- Haemophilus species
- Streptococcus species
- Klebsiella species
- Thromboembolism events
- There are several predisposing factor that can increase thromboembolism tendency, these factors are included:
- Decrease in anticoagulant factors such as, proteins C and S and antithrombin III
- Increased platelet aggregability
- Increase procoagulants proteins
- Hyperlipidemia
- Impaired fibrinolysis
- There are several predisposing factor that can increase thromboembolism tendency, these factors are included:
- Hyperlipidemia
- Malnutrition
- Anemia due to iron deficiency
- Hypocalcemia due to hyperparathyroidism secondary to vitamin D deficiency
Prognosis
Factors that worsen the prognosis of MPGN are included:[1]
- Hypertension at presentation
- Elderly individuals
- Low GFR at 1st year of presentation
Patients with MPGN type 1 and nephrotic syndrome have the chance of 50% to develop end-stage renal disease (ESRD) within 10 years and 90% in 20 years. Type II MPGN is some how more aggressive and 50% of patients eventuate in ESRD after 10 years of diagnosis.[2][3]
References
- ↑ Janette C.Cansick, Rachel lennon (2004). "prognosis, treatment and outcome of childhood mesangiocapillary". Nephrology Dialysis Transplantation.
- ↑ Michelle M. O’Shaughnessy, Maria E. Montez-Rath, Richard A. Lafayette and Wolfgang C. Winkelmayer (2015). "Differences in initial treatment modality for end-stage renal disease among glomerulonephritis subtypes in the USA". Nephrology Dialysis Transplantation.
- ↑ Sanjeev Sethi, M.D., Ph.D., and Fernando C. Fervenza, M.D., Ph.D. (2012). "Membranoproliferative Glomerulonephritis — A New Look at an Old Entity". The new england journal of medicine.