Treatment, clinical course and factors affecting clinical course in patients with membranous glomerulonephritis

Treatment, Clinical Course and Factors Affecting Clinical Course in Patients with Membranous Glomerulonephritis This study includes 43 patients who were diagnosed with pathologically MGN at Atatürk University Medical Faculty, Department of Internal Medicine, Nephrology Clinic. The data for disease of patients are based on records between 1998-2016. Demographic data, clinical findings, follow-up period, laboratory findings and treatments were investigated in the files examined. In our study, the ages of the patients ranged from 14 to 70 and the mean age was 36 ± 14. Twenty seven of the patients were male (63%) and 16 of patients were female (37%). At the time of admission to the hospital, creatinine levels ranged from 0.5 to 1.9 mg / dl, with a mean level of 0.94 ± 0.3 mg / dl. Proteinuria was present less than 1 g / day in nine of the patients (21%), 1-3.5 g/day in eight patients (18%) and at the nephrotic syndrome level (> 3.5 g/day) in 26 patients (61%). The mean albumin value was 2.5 ± 1 g/dl. Anemia was detected in 14% of the patients, hypertriglyceridemia was detected in 66% of patients and LDL cholesterol level was high in 74% of patients. During the follow-up period, 13 (30%) of the patients did not receive any immunosuppressive treatment and 30 of patients (60%) received one or more immunosuppressive drugs. The difference between the baseline values and last admissions values of albumin, proteinuria and creatinine were analyzed statistically by Paired-Sample t-Test. A statistically significant improvement in albumin and proteinuria was observed in patients receiving immunosuppressive therapy (p<0.01). A significant statistically improvement in proteinuria was also observed with the same test analysis in patients receiving only ACEI / ARB (p<0.01). However, the treatment success is not 100% and the presence of patients with progressive dissease although the therapy necessitates the development of additional treatment principles. In 23 of patients without statin treatment, there was a decrease in post-treatment LDL cholesterol values after immunosuppressive and non-immunosuppressive treatments, and this improvement was statistically significant. End-stage renal failure was developed in two patients, in the follow-up period and pulmonary emboli developed in one of our patients. As a result, in this thesis study, it was seen that the natural course of MGNs is largely stabil, and it is rarely seen as a progressive disease. According to the stage of the disease at the time of admission to the clinic and the following course of the disease, it was seen that immunosuppressive and non-immunosuppressive treatments with the right indications were effective in the treatment of the disease, they reduced progression of disease and these effects were statistically significant. Keywords: Membranous Glomerulonephritis, Demographics, Clinical Course, Treatment