Membranous glomerulonephritis natural history, complications and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Ahsan Hussain, M.D.[2]

Overview

The symptoms of membranous glomerulonephritis usually develop in the fourth decade of life in males. Approximately 5-30% patients with MN have spontanous remission. Common complications of membranous glomerulonephritis include renal failure, hypertension, proteinuria, dyslipidemia, hypercoagulable state leading to thromboembolism, Increased risk of infection. Prognosis is generally good, and 1 year mortality rate of patients with membranous glomerulonephritis is approximately 0.38%. The presence of proteinuria and baseline renal insuffiency are associated with a particularly poor prognosis among patients with membranous glomerulonephritis. Membranous glomerulonephritis caused by NSAIDS is associated with the most favorable prognosis.

Natural History

The natural history of membranous glomerulonephritis (MN) is given below:^[1]^[2]
- The symptoms of MN usually develop in the fourth decade of life in males.
- The presence of symptoms of MN young female is suggestive of lupus.
- Approximately 5-30% patients with MN have spontanous remission.

Complications

Common complications of membranous glomerulonepharitis include:^[3]^[4]
- Renal failure
- Symptoms associated with the nephrotic syndrome:
- Hypercoagulable state leading to thromboembolism
- Increased risk of infection

Prognosis

The prognostic factors of membranous glomerulonephritis are given below:^[5]^[6]
- Prognosis is generally good, and 1 year mortality rate of patients with membranous glomerulonephritis is approximately 0.38%.
- Depending on the extent of the membranous glomerulonephritis at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as good.
- The presence of proteinuria and baseline renal insuffiency are associated with a particularly poor prognosis among patients with membranous glomerulonephritis.
- Membranous glomerulonephritis caused by NSAIDS is associated with the most favorable prognosis.
- The prognosis of membranous glomerulonephritis associated with hepatitis B has less favorable prognosis.

References

↑ Kerjaschki D (2000). “Pathogenetic concepts of membranous glomerulopathy (MGN)”. J. Nephrol. 13 Suppl 3: S96–100. PMID 11132040.
↑ Schieppati A, Mosconi L, Perna A, Mecca G, Bertani T, Garattini S, Remuzzi G (July 1993). “Prognosis of untreated patients with idiopathic membranous nephropathy”. N. Engl. J. Med. 329 (2): 85–9. doi:10.1056/NEJM199307083290203. PMID 8510707.
↑ 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.
↑ Barbour S, Reich H, Cattran D (2013). “Short-term complications of membranous nephropathy”. Contrib Nephrol. 181: 143–51. doi:10.1159/000349976. PMID 23689576.
↑ Wasserstein AG (April 1997). “Membranous glomerulonephritis”. J. Am. Soc. Nephrol. 8 (4): 664–74. PMID 10495797.
↑ McGrogan, A.; Franssen, C. F. M.; de Vries, C. S. (2010). “The incidence of primary glomerulonephritis worldwide: a systematic review of the literature”. Nephrology Dialysis Transplantation. 26 (2): 414–430. doi:10.1093/ndt/gfq665. ISSN 0931-0509.

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[pmid11132040-1] Kerjaschki D (2000). “Pathogenetic concepts of membranous glomerulopathy (MGN)”. J. Nephrol. 13 Suppl 3: S96–100. PMID 11132040.

[pmid8510707-2] Schieppati A, Mosconi L, Perna A, Mecca G, Bertani T, Garattini S, Remuzzi G (July 1993). “Prognosis of untreated patients with idiopathic membranous nephropathy”. N. Engl. J. Med. 329 (2): 85–9. doi:10.1056/NEJM199307083290203. PMID 8510707.

[pmid24715030-3] 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.

[pmid23689576-4] Barbour S, Reich H, Cattran D (2013). “Short-term complications of membranous nephropathy”. Contrib Nephrol. 181: 143–51. doi:10.1159/000349976. PMID 23689576.

[pmid10495797-5] Wasserstein AG (April 1997). “Membranous glomerulonephritis”. J. Am. Soc. Nephrol. 8 (4): 664–74. PMID 10495797.

[McGroganFranssen2010-6] McGrogan, A.; Franssen, C. F. M.; de Vries, C. S. (2010). “The incidence of primary glomerulonephritis worldwide: a systematic review of the literature”. Nephrology Dialysis Transplantation. 26 (2): 414–430. doi:10.1093/ndt/gfq665. ISSN 0931-0509.

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