İdiyopatik Membranöz Glomerülonefrit Tanısı Alan Yetişkin Hastaların Değerlendirilmesi: Tek Merkez Deneyimi

Year 2025, Volume: 51 Issue: 2, 319 - 323, 28.08.2025

Cemile Peker , Alparslan Ersoy , Abdülmecit Yıldız

https://doi.org/10.32708/uutfd.1721258

Abstract

İmmünkompetan bir nefropati olan membranöz glomerülonefrit (MGN), nefrotik sendromun en yaygın nedenleri arasındadır. Spontan remisyon meydana gelebilse de, uzun vadeli son dönem böbrek yetmezliği gelişme riski vardır. MGN tedavi yaklaşımları konusunda tam bir fikir birliği yoktur; ancak immünosüpresif tedaviler kritik öneme sahiptir. Bu retrospektif, kesitsel çalışmaya, Mart 2007 ile Kasım 2015 tarihleri arasında merkezimizi ziyaret eden ve MGN tanısı alan 99 hasta dahil edilmiştir. Hasta verileri hastane bilgi sisteminden retrospektif olarak taranmış ve kaydedilmiştir. 99 hastanın 43’ü (%43,4) kadındı. Hastaların ortalama yaşı 46,7 yıl ve ortalama takip süresi 18,5 ay idi. Toplam 71 hasta (%71,7) nefrotik proteinüri ile başvururken, 57 hastada (%57,6) nefrotik sendrom vardı. 85 hastaya (%85,9) immünosupresif ilaç reçete edildi. İmmünosupresif tedavi görenler arasında 57 hastada (%79,9) tanı anında proteinüri devam ediyordu. İmmünosupresif tedavi uygulanan 63 hastada (%74,1) remisyon sağlanırken, konservatif tedavi uygulanan 10 hastada (%71,3) remisyon sağlandı. Hipertansiyon ve IgG birikimi, idiyopatik membranöz glomerülonefrit (MGN) tanısı alan hastalarda daha zayıf tedavi yanıtıyla ilişkili olabilir. Özetle, MGN, farklı yaş ve cinsiyetlerdeki bireyleri etkileyebilen nefrotik sendromun yaygın bir nedenidir. Çalışmamız, immünosüpresif tedavi gören hastalarda daha yüksek remisyon oranları tespit etmiş olup, bu durum, etkili hastalık yönetimi için bireysel risk faktörlerinin değerlendirilmesi ve uygun tedavi stratejilerinin seçilmesinin önemini vurgulamaktadır.

Keywords

Membranöz Glomerulonefrit , İmmunsupresif tedavi , Remisyon

Evaluation of Adult Patients Diagnosed with Idiopathic Membranous Glomerulonephritis: A Single-Center Retrospective Study

Abstract

Membranous glomerulonephritis (MGN), an immunocompetent nephropathy, is among the most prevalent causes of nephrotic syndrome. While spontaneous remission may occur, there is a risk of developing long-term end-stage renal failure. Treatment approaches for MGN lack full consensus; however, immunosuppressive therapies are critically important. This retrospective, cross-sectional study included 99 patients who visited our center between March 2007 and November 2015 and were diagnosed with MGN. Patient data were scanned and recorded retrospectively from the hospital information system. Of the 99 patients, 43 (43.4%) were female. The mean age of the patients was 46.7 years, with a mean follow-up duration of 18.5 months. A total of 71 patients (71.7%) presented with nephrotic proteinuria, while 57 patients (57.6%) had nephrotic syndrome. Immunosuppressive drugs were prescribed to 85 patients (85.9%). Among those receiving immunosuppressive therapy, 57 patients (79.9%) still exhibited proteinuria at the time of diagnosis. Remission was achieved in 63 patients (74.1%) who underwent immunosuppressive therapy, compared to 10 patients (71.3%) who received conservative treatment. Hypertension and IgG deposition may be associated with a poorer treatment response in patients diagnosed with idiopathic membranous glomerulonephritis (MGN). In summary, MGN is a common cause of nephrotic syndrome that can affect individuals of various ages and genders. Our study identified higher remission rates in patients treated with immunosuppressive therapy, which emphasizes the value of evaluating individual risk factors and selecting appropriate treatment strategies for effective disease management.

Keywords

membranous glomerulonephritis , immunosuppressive therapy , remission.

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