Fib GN Questions Part II

Our Research and Communications Continue

As the popularity of the former web page grows, and the length of the communication grows, I have decided to just begin another hub.

The deeper I dig into this disease, the more I want to learn. The effects of certain medications we may be put on, and other diseases that we may encounter from the effects of our disease, concerns me.

I am not trying to instill fear of this disease, I am simply informing of information I find as I dig through the web.

I hope I am doing the right thing in doing this research. I want to know what I am up against as my disease progresses.

Some Quick Biology Before We Begin

The kidney

Glomerulus/Nephron

FGN

Fibrillary glomerulonephritis. Randomly arranged microfibrillary deposits (diameter: 1823 nm). MES, mesangium.

Location Of Mesengium

The mesangium is an inner layer of the glomerulus, within the basement membrane surrounding the glomerular capillaries.

Glomeruli Loss & It's Effect On Our Bodies

The picture to the right shows the fibrils in the mesangium.

**The kidneys have the ability to monitor the amount of body fluid, the concentrations of electrolytes like sodium and potassium, and the acid-base balance of the body. They filter waste products of body metabolism, like urea from protein metabolism and uric acid from DNA breakdown. Two waste products in the blood can be measured: blood urea nitrogen (BUN) and creatinine (Cr).

~With FGN, this process gets screwed up because no matter what your kidneys are supposed to do in normal conditions, the filtering system is no longer allowing these other products of the body to be filtered out and passed through the urinary system, excluding protein. Thus causing problems such as hypertension, high blood pressure, and more.
**If enough glomeruli are damaged, kidney function is decreased. As a result, urine production falls and waste products build up in the blood.

~In some, but not all cases......

**Kidneys are also the source of erythropoietin in the body, a hormone that stimulates the bone marrow to make red blood cells. Special cells in the kidney monitor the oxygen concentration in blood. If oxygen levels fall, erythropoietin levels rise and the body starts to manufacture more red blood cells.

**Erythropoietin (EPO) A hormone produced by the kidney that promotes the formation of red blood cells in the bone marrow.

**Patients may have difficulty managing their phosphorus balance (phosphorus is excreted by the kidney) and often suffer from anemia. This occurs as the kidney can no longer secrete a substance called erythropoietin, a hormone responsible for stimulating bone marrow production of red blood cells.

~When your kidneys cannot secrete erythropoietin, in some cases, multiple myeloma occur.

**As kidney function decreases, the symptoms are related to the inability to regulate water and electrolyte balances, to clear waste products from the body, and to promote red blood cell production. Lethargy, weakness, shortness of breath, and generalized swelling may occur. Unrecognized or untreated, life-threatening circumstances can develop.

** Symptoms of advanced kidney failure include nausea, fatigue, confusion, loss of appetite, funny taste in the mouth, itching, shortness of breath, or heart palpitations. The rate of decline is variable ranging from months to several years and should be followed closely by your doctor.
~When our glomeruli fail to filter, plain and simple it ends in progressive renal failure.

The Acid-Base Balance Of The Body

The kidneys have the ability to monitor the acid-base balance of the body. When this process becomes altered, sometimes we experience acidosis.

**Many naturally occurring acids are necessary for life. For example, hydrochloric acid is secreted by the stomach to assist with digestion. The chemical composition of food in the diet can have an effect on the body's acid-base production.

Components that affect acid-base balance include protein, chloride, phosphorus, sodium, potassium, calcium, and magnesium. In addition, the rate at which nutrients are absorbed in the intestine will alter acid-base balance.

~As all of this is very informative, it has begun to make my head spin. But I will try to go on and link it all together.

Kidney failure can result in metabolic acidosis as far as the acid-base balance of the body goes. Prolonged acidosis can result in heavy or rapid breathing, weakness, and headache.

Most of the time our lungs will blow off extra oxygen to raise our Ph level in order to balnce the acid excess.

The Buildup Of Waste Products In The Blood

~The kidneys are responsible for eliminating metabolic waste products from the blood. There are "waste product tests" available, to test the proper function of the body's functions. Specifically the kidneys.

When certain waste products begin to build up in the blood, there may be consequences, such as: confusion, lethargy, coma, jaundice, joint inflammation such as RA, and gout.

In addition, all of the former may also lead to kidney disease. LOL Not funny, just comes around and about.

Factors that may affect a waste test would be pregnancy, a recent injury or illness and much, much more.

**Waste products:

Blood Urea Nitrogen (BUN):

High levels of BUN can also be found in those on high-protein diets and/or with strenuous exercise.

Goal values:

Male: 10 – 25 mg/dl
Female: 8 – 25 mg/dl

Serum Creatinine (CR): An indicator of kidney function

Goal value:

0.7 – 1.4 mg/dl

Uric Acid:

High levels of uric acid are also found in those with gout, arthritis and some metabolic disorders.

Goal values:

Male: 3 – 8 mg/dl
Female: 2 – 7 mg/dl

Urine Albumin Creatinine Ratio (U Alb:Cr):

Measures whether there is any protein in the urine. A small amount of protein in the urine is a risk factor for heart and blood vessel disease .

Goal values:

Less than 30 mg/g

**The normal kidney balances the internal chemistry of the body. The kidneys not only remove certain chemicals, but also keep other substances and chemicals the body needs. Potassium is one of the substances the body needs for normal heart and muscle function. When one eats food with potassium in it, the kidneys work to keep a normal level of potassium in the blood. If the kidneys are not working properly and the potassium builds up in the blood, then muscle function is affected, which may cause weakness. Too much potassium in the blood can also affect the heart, at times to a dangerous degree.
Urea and certain hormones may also build up. Also, when renal function is impaired, less calcium enters the body and bone disease can result.

Test your urine for protein and test your blood for creatinine.

Urinary albumin excretion is expressed per mg. creatinine in urine.

<30 mcg/mg = normal
30 mcg/mg - 300 mcg/mg = microalbuminuria
>300 mcg/mg = macroalbuminuria (significant proteinuria)

~Best if we leave this kind of testing to the doctors.

Transplantation Consideration_ B.S.

~Something I found while digging up research made me pretty angry. Once you read, you may agree, and it may spark a fire under you as it did to me to begin some kind of fund to evoke more research......

**When one encounters rapidly progressing glomerulonephritis or a pulmonary- renal syndrome in the immediate posttransplantation period, fibrillary glomerulonephritis must be considered in the differential diagnosis. Because of a high recurrence rate and no available treatment to modify a potentially malignant course of this disease, we recommend caution when considering these patients for transplantation.
(Am J Kidney Dis 1998 Nov;32(5):E4)