description
The membranous glomerulonephritis (or GEM) is a kidney disease characterized
by the appearance of a nephrotic syndrome. This is the most frequent cause of
nephrotic syndrome in adults. Its origin is often unknown, but there are 15% of
secondary forms revealing an underlying disease. the membranous
glomerulonephritis. Difficult to treat, it can lead to kidney failure requiring
dialysis or transplantation. The discovery of these genes define biomarkers of
membranous glomerulonephritis, which could greatly improve the monitoring and
prevention of disease.
causes
Nephrotic syndrome is caused by anatomic or functional abnormalities of the
glomerular basement membrane, which is normally impermeable to proteins from a
certain molecular weight (60000 daltons, or 60 kDa): the loss of the selectivity
results passage protein in the urine (which appears when the physiological
capabilities of tubular reabsorption of proteins are exceeded) and thus
proteinuria and hypoproteinemia (despite increased protein synthesis by the
liver).
symptoms
Glomerular disease that manifests clinically as proteinuria, and sometimes by
other devices nephrotic syndrome. Histologically it is characterized by deposits
in the capillary bed between glomerular epithelial cells and the basement
membrane and thickening of the membrane. Also features external projections of
the membrane between the epithelial deposits "transient." There are a number of
arguments that deposits are antibody-antigen complexes.
diagnostic
Vascular thrombosis, protein loss by fighting against platelet
aggregation,
1. hematuria, hypertension, renal failure
2. edema by decreasing the oncotic pressure of plasma,
3. infections, when there is leakage of immunoglobulins and complement,
4. Increased drug toxicity, by increasing the free fraction 5. drugs (which
are normally tightly bound to albumin, and 6. So Inactive: the decrease in
albumin concentration is responsible for an increase in the rate free, and
therefore active drug.)
7. dyslipidemia (increased cholesterol and triglyceride levels by stimulating
the liver)
Venous thrombosis have a special place in the GEM: thrombosis of one (or
both) renal vein is frequent but not specific to the disease. The prevention of
thrombosis is provided by anticoagulation, based on heparin or vitamin K,
indicated when serum albumin falls below 20 g / L.
treatments
In case of edema, the low-salt diet and diuretics are indicated in the usual
way: the combination of a loop diuretic and a product potassium-sparing
(amiloride or spironolactone) is often necessary.
Characteristic treatments
Micro-Chinese Medicine Osmotherapy
immunotherapy
immunotherapy
complications
Complications are possible throughout evolution.
infections:
Infections are:
- Very common.
- Favored by the lower rate of immunoglobulins and proposed treatments.
All types of infections can be observed but emphasize:
- Severity of lung infections.
- The gravity of any even trivial viral infection.
- The frequency of opportunistic infections, to parasites (nematode).
An appropriate antibiotic therapy is required in all cases.
thrombosis:
Thrombosis are also common, favored by hypercoagulability accompanying any
nephrotic syndrome.
Emphasize the renal vein thrombosis complicating especially extra-membranous
glomerulonephritis.
Nitrogen deficiency:
Nitrogen deficiency causes: muscle wasting, osteoporosis, malnutrition.
It is aggravated by corticosteroids.
Abdominal attacks:
The pathogenic hypotheses abdominal pain crises are numerous: mesenteric
edema, pancreatic, deep vein thrombosis.
Do not misunderstand acute appendicitis or peritonitis pneumonia.
Skin complications of chronic edema:
Cutaneous complications of chronic edema are the excoriations and
dermatitis.
A treat with care, as they are a gateway to infection.
Due to the time difference, your message within 48 hours to respond, please
understand. You fill the information will be kept confidential.
没有评论:
发表评论