Membranous Glomerulonephritis Follow-up

Updated: Oct 09, 2019
  • Author: Abeera Mansur, MD; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Follow-up

Further Outpatient Care

Management is on an outpatient basis, with emphasis on controlling blood pressure. Considerations include the following:

  • Observation for signs and symptoms of renal vein thrombosis, deep vein thrombosis, and pulmonary embolism is crucial
  • Renal function, proteinuria (measured by the ratio of urinary protein to creatinine), and electrolytes need to be monitored at regular intervals.
  • Additional monitoring is indicated for pharmacologic interventions.
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Complications

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  • Most complications are associated with heavy proteinuria.

  • Serositis is a possible complication.

  • Hypovolemia, with the possibility of acute renal failure, may occur in patients who are overdiuresed. Hypovolemia exacerbates the adverse renal effects of ACE inhibitors, ARBs, and NSAIDs.

  • Increased incidence of infection may be present, even in patients not receiving immunosuppressives.

  • Hyperfibrinogenemia and erythrocytosis may lead to a hypercoagulable state, particularly renal vein thrombosis. Nephrotic syndrome may also result in loss of antithrombin III.

  • Lethargy and tiredness are complications.

  • An increased incidence of ischemic heart disease has not been proven.

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Prognosis

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  • The outcome depends on the renal function at the time of diagnosis and the amount of proteinuria, ranging from remission without medication to ESRD.

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Patient Education

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