Question: My wife is 35 years old, suffer since 2003 of precence in urine of
proteinuria and hematuria.
In 2005 she had twin pregnancy (gone in good end) and she suffered arterial
hypertension and had a gestosi with anasarcatico framework.
She has not practiced examinations and specific therapies until Jan 2008 when
she practiced corticosteroid therapy local and systemic for generalized
itching.
March 2008 she noticed edemas slopes.
I send you documentation about general information and renal biopsy, the
final diagnosis was ’Nephrotic syndrome secondary to Membranous Nephropathy
.
At present the disease she suffering are: foam in urine, hypertension,
swelling legs, face, body.
The treatment at present is:medicine for hypertension and ’Lasix’ for
swelling.
No have heart disease, no high blood pressure, no vomiting, no
discomfort.
total protein: 5.0(6.5-8.2), albumin:3.0(3.6-5.2),Urea
Acid:6.7(2.4-5.7).RBC：3.79(4.0-5.4)HB:10.7(12-16), TUPR:3968(<150). We want
have a baby, what should we do?
Answer:
1. When I analyse your wife’s physical examination reports, I feel very pity
about her disease. Actually, she should have treatment in 2003, because she
present proteinuria and microscopic hematuria at that year. The clinical
symptoms of kidney disease always lag behind the pathological damage, that means
if the patient present the symptoms like foam in urine,hematuria,backpain,high
blood pressure etc, that means her kidneys have already damaged. Therefore, if
the patient is in the stage of CKD3( Chronic Kidney Disease 3), he should
receive CKD 4 treatment to protect his kidneys and delay the development of
kidney disease.
2. I don’t suggest your wife get pregancy if her disease can’t be controlled
well. Because the damaged kidneys will not only increase the burden of the
mother, but also for the fetus. What’s more, she has received corticosteroid
therapy, which is a kinds of hormone medicines, has a lot of side-effect. If she
still take this medicines, which is not easy for her to get pregancy.
In the attachement, there are the side-effect of hormones medicines.
3. What is the meaning of anasarcatico framework? Are you sure the spelling
is right?
4. I have analysed your wife’s physical examination reports, I can undersand
most of the reports, but only the renal biopsy reports I can’t not understand.
Most of the words are Italian, we don’t have intalian patient at present, so we
can’t understand.
Can you translate the renal biopsy into English? I only need the main
information like how many glomeruli get damaged, dead/necrotic, sclerosis
etc.
I suggest your wife do a renal function test, I need to know her
GFR(Glomerular Filtration Rate).