|
IgM mesangial proliferative glomerulonephritis Causes and Risks:
IgM mesangial proliferative glomerulonephritis is a form of glomerulonephritis (inflammation of the kidney glomeruli) . The mesangial cells (part of the glomerular capillaries) increase in size, giving the glomeruli a lumpy appearance. The mechanism that triggers the disorder is unknown, but it is believed to be some type of immune response , because inflammation of the glomeruli is associated with deposits of IgM (a type of antibody ).
The disorder usually causes nephrotic syndrome ( protein loss in the urine and swelling of the body). It may be present as acute , chronic , or rapidly progressive glomerulonephritis , and may progress to chronic renal failure .
It is a rare disorder, affecting 3 out of 10,000 people. It can affect both adults and children. Men may be affected slightly more often than women.
Prevention:
unknown
Symptoms:
Signs and Tests:
Examination is nonspecific except for edema . Signs of acute or chronic renal failure may be present, including high blood pressure , low urine output , and fluid overload.
Treatment:
Treatment goals are to relieve symptoms and prevent of complications. The disorder is usually chronic , requiring prolonged treatment.
Corticosteroid, immunosuppressive, antihypertensive, and diuretic medications may be given in an attempt to control symptoms and retard progression of the disorder. Although the presence of antibodies indicates there is some type of immune response causing the disorder, suppression of the immune system with corticosteroids and immunosuppressives may not reduce symptoms in all cases.
Treatment of high blood cholesterol and triglyceride levels may be recommended to reduce the development of atherosclerosis . Dietary limitation of cholesterol and saturated fats may be of only limited benefit because high levels of cholesterol and triglyceride associated with this disorder appear to be caused by overproduction by the liver rather than excessive intake of fats. Medications to reduce cholesterol and triglycerides may be recommended.
High-protein diets are of debatable value. In many patients, reducing the amount of protein in diet produces a decrease in urine protein . A moderate-protein diet (1 gram/kilogram of body weight/day) is usually recommended. In cases of renal failure , a low-protein diet is recommended to reduce the accumulation of dangerous nitrogen containing wastes (a by-product of protein metabolism ).
Sodium (salt) and fluids may be restricted to help control swelling . Vitamin D may need to be replaced if nephrotic syndrome develops that is unresponsive to therapy.
Prognosis:
The outcome varies. The disorder may be acute and short-term, or chronic and unresponsive to therapy. Complications can affect the outcome.
Complications:
Call Your Healthcare Provider:
Call your health care provider if symptoms indicate mesangial proliferative glomerulonephritis may be present.
Call your health care provider if decreased urine output or other new symptoms develop.
The kidneys are responsible for removing wastes from the body, regulating electrolyte balance and blood pressure, and the stimulation of red blood cell production. The gross anatomical structure of the kidney is illustrated.
|
