Membranous nephritis

Membranous Nephritis (MN), also known as Membranous Glomerulonephritis (MGN), is a kidney disorder characterized by the thickening of the glomerular basement membrane within the kidney. This condition is one of the leading causes of Nephrotic Syndrome in adults. It occurs when the immune system mistakenly attacks and damages the kidney's filtering units, leading to significant proteinuria (excess protein in the urine) and potential kidney failure.

Causes

Membranous Nephritis can be primary (idiopathic) or secondary. Primary MN has no identifiable cause, whereas secondary MN is associated with other conditions such as Systemic Lupus Erythematosus, Hepatitis B, Hepatitis C, Malaria, and certain medications or cancer. The disease is thought to be an autoimmune disorder, where the body's immune system mistakenly attacks the phospholipase A2 receptor (PLA2R) on the podocytes, cells in the kidney that help filter waste and fluids.

Symptoms

The symptoms of Membranous Nephritis can vary and may include:

• Proteinuria - High levels of protein in the urine, leading to frothy urine
• Edema - Swelling in parts of the body, most notably the legs, ankles, and around the eyes
• Hypertension - High blood pressure
• Hyperlipidemia - Elevated levels of lipids in the blood
• Fatigue
• Weight gain due to fluid retention

Diagnosis

Diagnosis of Membranous Nephritis involves a combination of clinical evaluation, laboratory tests, and kidney biopsy. Laboratory tests may include urine analysis to check for proteinuria and blood tests to assess kidney function. A kidney biopsy is the definitive test for diagnosing MN, where a small sample of kidney tissue is examined under a microscope for characteristic signs of the disease.

Treatment

Treatment for Membranous Nephritis aims to reduce symptoms, prevent complications, and slow the progression of the disease. Options may include:

• Angiotensin-converting enzyme inhibitors (ACE inhibitors) or Angiotensin II receptor blockers (ARBs) to reduce proteinuria and control blood pressure
• Immunosuppressive therapy, such as corticosteroids and cyclophosphamide, for patients with severe or progressive disease
• Management of edema with diuretics
• Lifestyle changes, including dietary modifications and exercise

Prognosis

The prognosis for individuals with Membranous Nephritis varies. Some patients may experience spontaneous remission, while others may progress to chronic kidney disease or end-stage renal disease, requiring dialysis or kidney transplantation.

Epidemiology

Membranous Nephritis is more common in adults than in children, with a higher prevalence in males compared to females. The incidence of MN varies globally, with an estimated annual incidence of 1-2 cases per 100,000 individuals.

See Also

• Glomerulonephritis
• Nephrotic Syndrome
• Chronic Kidney Disease
• Autoimmune Diseases