Membranous glomerulonephritis is sometimes referred to as nephropathy or nephritis due to their similarities. The only difference is the presence of inflammation. When children suffer from nephropathy, it can be serious, but the good news is that it’s pretty rare in children. However, in 50 percent of cases involving younger individuals, there are signs of progressive kidney disease. Despite age, MGN can lead to complications, including blood clots, high cholesterol, high blood pressure, and kidney failure.
What are the causes of membranous glomerulonephritis?
Membranous glomerulonephritis causes continue to be researched, but what we can tell you is that nephropathy is caused by thickening of part of the kidney that filters waste and extra fluid from the blood. This part is called the glomerular basement membrane and unfortunately, the exact reason for the thickening of this membrane is still unknown.
When the glomerular membrane thickens, it doesn’t work properly, so large amounts of protein are lost in the urine.
Membranous glomerulonephritis can develop as what we call a “primary disease,” which means it is not caused by another condition. MGN can also occur due to an underlying health condition. For instance, a person is more likely to get MGN if they have been exposed to toxins or have experienced cancer, hepatitis B, or autoimmune disorders. You are also at higher risk if you have had a kidney or bone marrow transplant or use certain medications, such as nonsteroidal anti-inflammatory drugs or skin-lightening creams.
Symptoms of membranous glomerulonephritis
Some people with membranous glomerulonephritis don’t experience any symptoms, while others develop symptoms slowly over time. Below is a list of the typical signs and symptoms of MGN:
- Fatigue
- Foamy urine
- Blood in urine
- Swelling of hands, feet, or face
- Excessive need to urinate at night
- Weight gain
- Poor appetite
Membranous glomerulonephritis stages
There are four membranous glomerulonephritis stages. Below are those stages briefly outlined to give you a sense of how the condition progresses.
- Stage 1—stiffness of the capillary wall can be detected, but it is impossible to detect thickening of the wall. The mild stiffness is seen as silver staining and can be found thanks to a technique called immunofluorescence and electron microscopy.
- Stage 2—there is glomerular enlargement and diffuse thickening of the capillary. Also, red deposits can be detected and extensions of the glomerular membrane, which look like black spikes, appear.
- Stage 3—more deposits and more thickening of the basement membrane become evident. The once silver staining now look like holes in the membrane.
- Stage 4—further thickening of the membrane can be seen and in some cases, lesions appear.
Diagnosis of membranous glomerulonephritis
If you are experiencing MGN symptoms, you will want to see a doctor as soon as possible. You will undergo a physical exam that could include a urinalysis to determine if you have protein in your urine. There are also a series of other tests that can be conducted to help confirm the diagnosis.
- Blood and urine albumin tests—an albumin test checks urine for a protein called albumin, which is normally found in the blood and filtered by kidneys. When kidneys are damaged, abnormal amounts of albumin leak into the urine.
- Blood urea nitrogen (BUN)—a BUN test measures the amount of nitrogen in your blood that comes from the waste product urea. It can tell a doctor how well your kidneys are working.
- Creatinine blood—this test measures creatinine in the blood. Creatinine is found in muscle.
- Creatinine clearance—allows a doctor to compare creatinine level in urine with creatinine level in blood and estimate glomerular filtration rate, which is a measure of how well the kidney’s filtering units are working.
- Lipid panel—this is a type of blood test that measures lipids-fats used as a source of energy by the body. Lipids include cholesterol, triglycerides, and lipoprotein.
If membranous glomerulonephritis is suspected, the doctor may order a kidney biopsy.
Membranous glomerulonephritis treatment
Every case requires a different approach when it comes to membranous glomerulonephritis, but the goal is always the same: reduce the symptoms and slow down the progression of the disease.
When it comes to delaying kidney damage, one of the best ways to treat people is to control blood pressure. The idea is to keep blood pressure at or below 130/80 mm Hg. Medications commonly referred to as ACE and ARBs are used frequently to help lower blood pressure. At the same time, some individuals are prescribed corticosteroids or other medications to help suppress the immune system. Water pills and reducing salt intake can help with swelling.
A diet low in fat and low in cholesterol can be helpful for people who suffer from MGN or membranous nephropathy. Some research suggests that a low protein diet may be helpful, as well as vitamin D.
Membrane glomerulonephritis only occurs in about two out of 10,000 people. While you can get it at any age, it is more common in people over the age of 40. The outlook for each person diagnosed with MGN is different. It largely depends on the amount of protein loss. For some sufferers, there are symptom-free periods followed by occasional flare-ups. Sadly, there are people with the condition that will experience kidney damage and end-stage renal disease.
If you have symptoms of MGN or membrane nephropathy, and if you experience a decrease in urine output, you should seek medical care.