Membranous nephropathy is a kidney disorder which involves changes and inflammation of the structures inside the kidney that help filter waste and fluids. The inflammation leads to problems with kidney function.
Membranous nephropathy is caused by thickening of part of the glomerular basement membrane. 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 following increase your risk for this condition:
- Exposure to substances or medications, including gold, mercury, penicillamine, trimethadione, and skin-lightening creams
- Hepatitis B
- Non-Hodgkin's lymphoma
- Solid cancerous tumors
- Systemic lupus erythematosus
The disorder occurs in approximately 2 out of 10,000 people. It may occur at any age but is more common after age 40.
- Edema (swelling) in any area of the body
- Foamy appearance of urine
- Weight gain
- Poor appetite
- Urination, excessive at night
- High blood pressure
Note: Symptoms vary and in many cases there are no symptoms at all.
A physical exam may show swelling (edema).
Serum albumin may be low. Blood lipid levels may increase.
Kidney biopsy confirms the diagnosis of membranous nephropathy.
The goal of treatment is to reduce symptoms and slow the progression of the disease.
Symptoms should be treated as appropriate. Medications vary and may include corticosteroids, immunosuppressive drugs, blood pressure medications, and antibiotics (to control infections).
High blood cholesterol and triglyceride levels should be treated to reduce the risk of atherosclerosis secondary to nephrotic syndrome. A low-fat, low-cholesterol diet may be of limited benefit as the high levels of cholesterol and triglyceride seem to be caused by overproduction by the liver rather than eating too much fat. Medications to reduce cholesterol and triglycerides may be recommended.
The value of a high-protein diets has been debated. In many patients, reducing the amount of protein in the diet produces decrease in protein in the urine. In most cases, a moderate-protein diet (1 gram of protein per kilogram of body weight per day) is usually recommended.
This disease increases the risk for blood clots in the lungs and legs.Patients are occasionally prescribed blood thinners to prevent these complications.
The outlook varies. There may be symptom-free periods and acute flare ups. In some cases, the condition may go away with or without therapy.
- Nephrotic syndrome
- Chronic renal failure
- End-stage renal disease
- Renal vein thrombosis
- Pulmonary embolism
Call for an appointment with your health care provider if symptoms indicate membranous nephropathy may be present. Call for an appointment with your health care provider if symptoms worsen or persist, if you experience a decreased urine output or other new symptom develops.
Promptly treating associated disorders and avoiding associated substances may reduce risk.
Reviewed By: Charles Silberberg, DO, Private Practice specializing in Nephrology, Affiliated with New York Medical College, Division of Nephrology, Valhalla, NY. Review provided by VeriMed Healthcare Network.