Clinical manifestations of membranous glomerulonephritis

Idiopathic membranous nephropathy can occur at any age, more common in adults, average age 35 years old, male to female ratio of about 1.5 to 2:1. Insidious onset, a small number of precursor infection after the onset. The first symptom of 15% to 20% of asymptomatic proteinuria, 80% with nephrotic syndrome, non-selective proteinuria.Microscopic hematuria in adults about 60% of children with gross hematuria, but rarely see the red tube. Early blood pressure more than normal, with about 50 percent of the progression of high blood pressure, relax and disappear with kidney disease. In the early days, the renal function is normal. 80% have varying degrees of edema, severe chest, ascites, and other body cavity effusions, the mechanism is multifactorial. There are two serious complications of idiopathic membranous nephropathy: ① high coagulation disorder and renal vein thrombosis: increased levels of blood coagulation factor due to nephrotic syndrome, enhanced platelet adhesion and cohesion, antithrombin Ⅲ Kangxian plasmin activity increased, resulting from high-blood clotting disorder.Dexamethasone can promote coagulation. This disease is about 50% of the incidence of renal vein thrombosis, no obvious symptoms, but the nephrotic syndrome increase the more common chronic form. Acute type can show the sudden appearance of low back pain, often more severe, accompanied by the kidney area, hit pain, hematuria, often gross hematuria, white blood cells in urine, a sudden increase in proteinuria, hypertension and acute renal dysfunction, bilateral renal vein thrombosis even oliguria and acute renal failure, the kidneys were increased. Chronic type of renal tubular dysfunction in performance such as: renal glucosuria, amino acids, urine, and renal tubular acidosis. In addition, it may be complicated by pulmonary embolism. Can also occur such as: brain, heart, legs, and extra-renal thrombosis. Clear diagnosis of the need for renal vein or renal artery angiography, radioactive renography and CT are also helpful in the diagnosis. ② combined anti-GBM crescentic glomerulonephritis: the basement membrane damage, membrane antigen exposure or release can lead to the formation of anti-basement membrane antibodies. May be detected in the serum anti-basement membrane antibodies, anti-neutrophil antibodies (ANCA). Therefore, if medically stable patients with rapid renal dysfunction and rapidly progressive glomerulonephritis-like performance, should be highly alert to the possibility of complications.