Membranous glomerulonephritis natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Ahsan Hussain, M.D.[2]
Overview
Common complications of membranous glomerulonephritis include renal failure.
Natural History
- The symptoms of Membranous glomerulonephritis usually develop in the fourth decade of life in males. [1] [2]
- The symptoms of membranous glomerulonephritis typically develop in young women increases the susceptibility of lupus.
Complications
- Common complications of membranous glomerulonepharitis include:
- Renal failure[2]
Prognosis
- Spontaneous remission is most likely in women, children, those with lesser amounts of proteinuria, and adults under age 50 years with a normal serum creatinine concentration and benign histologic features.
- Although unproven, the rate of partial remission may be higher with the use of ACE inhibitors or ARBs.[3]
- Probability of progression — Based upon a study of 184 patients identified through the Toronto Glomerulonephritis Registry, a semiquantitative algorithm has been developed to predict the probability of progression to chronic kidney disease, which was defined as a creatinine clearance ≤60 mL/min per 1.73 m2.
- The probability of progression was assessed for those with 4, 6, and 8 g/day of proteinuria that persisted for 6, 9, 12, or 24 months.
- Multiple additional variables (including age, sex, serum creatinine, and creatinine clearance on presentation, serum albumin, presence of hypertension, rate of change of creatinine clearance, and therapy) were also tested to determine whether the predictive value provided by proteinuria could be improved. Of these variables, the initial creatinine clearance and the rate of change of clearance were the most useful predictors.
References
- ↑ Glassock RJ (July 2010). "The pathogenesis of idiopathic membranous nephropathy: a 50-year odyssey". Am. J. Kidney Dis. 56 (1): 157–67. doi:10.1053/j.ajkd.2010.01.008. PMID 20378220.
- ↑ 2.0 2.1 Debiec H, Ronco P (July 2014). "Immunopathogenesis of membranous nephropathy: an update". Semin Immunopathol. 36 (4): 381–97. doi:10.1007/s00281-014-0423-y. PMID 24715030.
- ↑ Kerjaschki D (2000). "Pathogenetic concepts of membranous glomerulopathy (MGN)". J. Nephrol. 13 Suppl 3: S96–100. PMID 11132040.