Treatments of Membranous Nephropathy

• Membranous Nephropathy(MN) is one of the main causes of adult Primary Nephrotic Syndrome. The pathological characteristic of the disease is the diffuse deposition of immune complex under the glomerular epithelial and the thickening of the glomerular basement membrane without obvious inflamation. So far, the pathogenesis of Membranous Nephropathy is still not clear. And the controversy about treatments of the disease is also heated. The following are some conventional treatments of Membranous Nephropathy.

  1. Immunotherapy

  In addition to symptomatic treatment, the main treatment of Membranous Nephropathy is immunotherapy. At present, the most common immunosuppressants mainly are as follows:

  ◆ Glucocorticoid

  It is found that after the glucocorticoid treatment, the symptom of Nephrotic Syndrome in more than half of the patients with Membranous Nephropathy can be relieved, and the probability of suffering from renal insufficiency is obviously lower than that of the placebo. However, by the same treatment, it is also found that there is no difference between the glucocorticoid treatment and placebo.

  ◆ Glucocorticoid combined with cytotoxic drugs

  At present, the combination treatment of glucocorticoid and cytotoxic drugs(such as cyclophosphamide, chlorambucil, etc.) is also adopted clinically. And it is believed that the combination therapy can promote the response rate of proteinuria of patients with Membranous Nephropathy, and prevent the development of Renal Failure. But there are also some others who believe that, for patients with no response after the glucocorticoid treatment, the using of cytotoxic drugs will have no effect in treating Membranous Nephropathy either. It only can have effects on patients with Membranous Nephropathy whose condition has been improved by glucocorticoid treatment. Cytotoxic drugs should be used carefully, because the side effects of itself is obvious, such as the suppression of bone marrow, the decrease of white blood cells, etc.

  2. Symptomatic treatment

  Symptomatic treatment mainly includes the following items:

  ◆ A reasonable daily life

  ◆ A appropriate protein diet

  ◆ Promoting urination

  ◆ Decreasing the blood pressure

  3. Traditional Chinese Medicine

  It is found domestically that Traditional Chinese Medicine have the following effects in treating Membranous Nephropathy:

  ◆ Reducing the urine protein of patients with Nephrotic Syndrome

  ◆ Reducing the recurrence of Membranous Nephropathy

  ◆Relieving the adverse reactions of hormone and immunosuppressants.

  Membranous Nephropathy should be treated according to the criticality of patients. And before adopting immunosuppressants, we should take fully consideration of the ratio of curative effect and risk, and reduce the adverse reactions and complications of patients with Membranous Nephropathy.

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