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A friend is diagnosed with chronic extramembranous glomerulonephritis, what is the risk of renal failure, and what are the other risks?
30 نوفمبر 2015
رأي ثانوي

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د. Bassem Tanios طب أمراض الكلى
extramembranous glomerulonephritis or membranous glomerulonephritis is a disorder affecting the kidneys. Some cases are termed secondary, that means that they they are a results of some infections or cancers, and this type of membranous nephropathy should be worked up to identify these causes, because when these causes are treated, the inflammation in the kidneys will resolve. If no secondary cause is identified, then it is termed primary membranous glomerulonephritis. Primary membranous glomerulonephritis is usually a slowly progressive disease, and a small proportion may progress to renal failure. Some cases of primary glomerunephritis will resolve spontaneously. Mild cases are treated with lifestyle interventions such as a low salt diet, and some medications to control blood pressure we call RAAS blockers. A small proportion of cases are severe enough with a high risk of progression to renal failure and should be treated with immunosuppressive medications to control the inflammation in the kidneys. It all depends on the level of kidney function as determined by the creatinine level in the blood, and the level of protein in the urine ( proteinuria).
Sometimes when the quantity of protein lost in the urine is very high, the patient will be predisposed to have increased risk of blood clotting, such as thrombosis of veins in the legs, and this is usually managed with blood thinners until the inflammation in the kidneys is treated and thus protein in the urine decreases. Also this can lead sometimes to increased cholesterol in the blood, which will predispose to cardio-vascular problems. In any case, your friend should maintain a close follow-up with a specialist ( a Nephrologist), who is the most competent to make the diagnostic and therapeutic decisions to prevent or delay progression to renal failure, and prevent other problems that are associated with this condition.
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