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Tests and diagnosis
By Mayo Clinic staffThe main sign of membranous nephropathy is the loss of protein, primarily albumin, from the blood into the urine (proteinuria). An otherwise healthy person would excrete less than 50 milligrams (one-thousandth of an ounce) of albumin a day in the urine. Someone with membranous nephropathy may excrete several hundred milligrams of albumin a day, up to more than 10 grams (four-tenths of an ounce) with advanced disease.
Tests used to determine the cause of the disease and how well your kidneys are functioning include:
- Urine tests to determine the amount of protein in the urine — urine creatinine estimates the concentration of your urine
- Glomerular filtration rate (GFR), which tells how much kidney function you have
- Cholesterol and triglyceride (lipids) levels in your blood
- Fasting blood sugar and glycosylated hemoglobin tests for diabetes
- An antinuclear antibody test for collagen vascular disease
- Screening blood tests for autoimmune diseases
- Tests for hepatitis B and C
- Ultrasound or CT scans to examine the structure of your kidneys and urinary tract
Removing a small piece of your kidney tissue for a pathologist to examine under a microscope (kidney biopsy) is the best way to identify the kind of kidney disease, to see how much damage has occurred and to evaluate the effectiveness of treatment.
- Appel GB. Glomerular disorders and nephrotic syndromes. In: Goldman L, et al. Cecil Medicine. 24th ed. Philadelphia, Pa.: Saunders Elsevier; 2011. http://www.mdconsult.com/das/book/body/191371208-2/0/1492/0.html#. Accessed June 9, 2011.
- Fervenza FC, et al. Idiopathic membranous nephropathy: Diagnosis and treatment. Clinical Journal of the American Society of Nephrology. 2008;3:905.
- Swaminathan S, et al. Changing incidence of glomerular disease in Olmsted County, Minnesota: A 30-year renal biopsy study. Clinical Journal of the American Society of Nephrology. 2006;1:483.
- Beck LH, et al. Causes and diagnosis of membranous nephropathy. http://www.uptodate.com/contents/causes-and-diagnosis-of-membranous-nephropathy. Accessed June 9, 2011.
- Cattran D. Treatment of idiopathic membranous nephropathy. http://www.uptodate.com/contents/treatment-of-idiopathic-membranous-nephropathy. Accessed June 9, 2011.
- Coping effectively: A guide to living well with kidney failure. National Kidney Foundation. http://www.kidney.org/atoz/pdf/coping.pdf. Accessed July 18, 2011.
- What is proteinuria? National Kidney & Urologic Diseases Information Clearinghouse. http://kidney.niddk.nih.gov/kudiseases/pubs/proteinuria/. Accessed July 18, 2011.
- Fervenza FC, et al. Rituximab therapy in idiopathic membranous nephropathy: A 2-year study. Clinical Journal of the American Society of Nephrology. 2010;5:2188.
- Fervenza FC, et al. Rituximab in idiopathic membranous nephropathy. Kidney International. 2008;73:117.
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