The doctor will not tell you these questions:
1, membranous nephropathy is how to produce?
2, why membranous nephropathy is difficult to treat?
3, the current treatment of membranous nephropathy What is the new method?
Why is membranous nephropathy?
The reason is called the name because of the pathological type of glomerular capillary epithelial side of the visible large number of immune complex deposition, glomerular basement membrane thickening as the main pathological features.
Membranous nephropathy is divided into idiopathic and secondary two, secondary membranous nephropathy is mainly caused by lupus erythematosus, diabetes, rheumatoid arthritis, hepatitis B virus, cancer.
Therefore, membranous nephropathy is a classic immune nephropathy.
Why membranous nephropathy refractory?
Clinically, according to the pathological changes under electron microscopy, membranous nephropathy is divided into four phases:
Phase I: few deposition of immune complexes, the basement membrane structure is complete.
At this point the patient has only a small amount of urine protein, is the best time to treat, but without the habit of regular physical exams, it is likely to miss.
Stage II: Immune complex deposition gradually increased, basement membrane began to proliferate thickening, and glomerular epithelial cells nail-like changes, podocyte damage began to be serious.
Urinary protein gradually increased at this time, but not yet reached a large number of urinary protein (greater than 3.5g / 24h), generally does not appear nephrotic syndrome, is still the best time to treat.
Three: irregular thickening of the basement membrane, there is irregular stratification, podocyte damage is serious, and the phenomenon of foot process fusion.
At this point urinary protein has reached 3.5g / 24h or more, began to appear nephrotic syndrome characteristics, treatment began to become difficult, mainly due to the hormone effect decreased, it is because of foot process fusion barrier damage.
Four: extremely thick basement membrane, mesangial proliferation, glomerular sclerosis.
Instead, urinary protein began to decline, but this does not mean that the condition has improved, but because of renal function began to decline. When endogenous creatinine clearance rate down to a certain stage, serum creatinine began to rise, membranous nephropathy also developed to the stage of chronic renal failure.
Progress in the treatment of membranous nephropathy
Traditional means of treatment of membranous nephropathy is sufficient hormone elimination of urinary protein, while supplementing plasma proteins and control complications such as hypertension.
But here's a problem: the culprit in glomerular epithelial damage - immune complexes - has not been cleaned up.
The reason why the first and second phases of membranous nephropathy is easier to treat is because less immune complexes are deposited. As long as the inflammatory response is controlled by hormones, the compensatory nature of the kidney itself can ensure the normal needs of the human body.
However, this does not mean that the immune complexes have been cleared, so although the urinary protein has temporarily disappeared, the damage to the kidneys continues.
The third phase, with the basement membrane thickening and podocyte damage more and more serious, both the mechanical barrier and the charge barrier have been severely damaged, although the hormone can inhibit protein leakage, but when the hormone is reduced to a certain extent Usually reduced to about 3), it is easy to relapse.
Therefore, membranous nephropathy early clearance of immune complexes is very important.
Clean immune complexes, can use the traditional Chinese medicine "Tong Fu Huayu" treatment concept, the use of rubbed, hot compress, medicated bath directly to the lesion administration, one can protect the damaged nephron, and secondly to clean up the deposition Immune complex.
Therefore, in the early stage of membranous nephropathy (phase I and phase II), adding Chinese medicine treatment on the basis of western medicine hormone therapy can greatly delay the progression of the disease, and may even limit the condition for a long time to be within the second phase.
By the third and fourth stages, although Chinese medicine can not fully restore the fused foot process and impaired podocytes, it can enhance the activity of the remaining nephrons and delay the rate of renal failure by improving microcirculation.
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