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Membranoproliferative glomerulonephritis

 

Glomerulonephritis is an alteration of the glomerular portion of the kidney.

The membranoproliferative glomerulonephritis (MPGN) is characterized by proliferation of mesangial cells and an increase of mesangial matrix, with diffuse thickening of the glomerular capillary wall.

Two main types of membranoproloferative glomerulonephritis are distinguished according to the location of the deposits:

  • type I, with subendothelial deposits (70%)
  • type II, with localized deposits on the basement membrane itself (20%)

Why is it produced?

The etiology is related to infections in some cases, but in others it is idiopathic (with no apparent cause).

Membranoproloferative glomerulonephritis is associated with several infectious, autoimmune, neoplastic or metabolic diseases. It should be noted that the numerically most important group is made up of various infections (viruses, bacteria and parasites). It is suggested that these infectious agents act as antigens in the circulating immune complex formation mechanism, which is presumed to operate in membranoproliferative glomerulonephritis.

There is a pathogenic relationship between glomerular injury and complement activation. Thus, hypocomplementemia could be involved by increasing susceptibility to infections, favoring the development and persistence of circulating immune complexes.

Symptoms of membranoproliferative glomerulonephritis

The disease affects all age groups, mainly children and young adults.

The onset of the disease occurs with nephrotic syndrome in 50% of cases (associated with recurrent micro or macrohematuria).

Nephrotic syndrome is a clinicopathological entity characterized by renal and extrarenal manifestations, especially proteinuria, hypoalbuminemia, edema, hyperlipidemia, lipiduria, and hypercoagulability.

The essential component of this syndrome is proteinuria (excess protein in the urine), due to the abnormal permeability of the glomerular filtration barrier for proteins.

20% of the cases present an acute nephritic syndrome, characterized by oliguria (little urine), gross hematuria (visible blood in the urine), arterial hypertension , edema, and kidney failure.

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Approximately 30% present with asymptomatic urinary disorders (non-nephrotic proteinuria and microhematuria (blood not visible in the urine)). In one third of cases there is a history of a previous infection, usually respiratory or tonsil. Renal failure from the beginning indicates a worse prognosis.

Diagnosis

The clinical findings are essential and, of course, the laboratory tests, such as: biochemistry, hemogram, systematic and urine sediment, specific serological tests (complement, antinuclear antibodies, anti-DNA, antineutrophil cytoplasmic antibodies).

Kidney biopsy

Performing a biopsy is determined by the age of the patient. Thus, nephrotic syndromes in adults are all biopsied, whereas renal biopsy is not indicated in children 1 to 10 years with cortico-sensitive nephrotic syndrome. This test is essential for the proper diagnosis, prognosis, and treatment.

Treatment of membranoproliferative glomerulonephritis

The treatment of membranoproliferative glomerulonephritis depends in part on its idiopathic or secondary nature. Generally, when it is secondary, an adequate treatment of the etiological process carries a better prognosis than in idiopathic membranoproliferative glomerulonephritis.

They have been used for the treatment of cortico-steroids and other immunosuppressive drugs; anticoagulants and antiplatelet agents, to reduce glomerular damage from coagulation, and non-steroidal anti-inflammatory agents. The results with these treatments have been very disappointing, as none of them have been fully effective. Therefore, it is very difficult to recommend a therapeutic strategy in each case.

How can I avoid it?

The origin of the disease is unknown, therefore we cannot prevent it.

What we must do is go to the doctor as soon as we have the symptoms described above so that they treat us and monitor us properly.

 

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Hello Readers, I am Nikki Bella a Psychology student. I have always been concerned about human behavior and the mental processes that lead us to act and think the way we do. My collaboration as an editor in the psychology area of ​​Well Being Pole has allowed me to investigate further and expand my knowledge in the field of mental health; I have also acquired great knowledge about physical health and well-being, two fundamental bases that are directly related and are part of all mental health.

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