Membranous Nephropathy Flashcards
Aetiology?
Autoimmune
What are there autoantibodies to in membranous nephropathy?
Glomerular basement membrane
What is the receptor that is targeted in membranous nephropathy?
M type phospholipase A2 receptor
What is the pathology of membranous nephropathy?
Inflamed and damaged GBM
Subepithelial deposits of immune complexes that active the compliment pathway and attack podocytes and mesangial cells leading to GBM matrix being deposited hence MEMBRANOUS NEPHROPATHY
Symptoms?
Nephrotic syndrome
What is nephrotic syndrome?
> 3.5g/day proteinuria
Hypoalbuminaemia (oedema)
Hyperlipidaemia (lipiduria)
Investigations?
Renal biopsy
What should be done with the renal biopsy?
Histology
Electronmicroscopy
Immunofluorescence
What is shown on histology in membranous?
Thickened GBM
What is shown on immunofluorescence in membranous?
Granular deposits
Treatment?
Loop diuretic
Immunosuppression
When should immunosuppression be done?
Rising proteinuria
Rising creatinine
What other management for membraneous?
Salt and fluid restriction
Daily weight
