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Gold and penicillamine nephropathy (kidney damage): Treatment, symptoms, advice and help

About gold and penicillamine nephropathy (kidney damage)

Nephropathy is a medical term used to signify kidney damage. It is characterised by inflammatory disruption of the filtration process. This results in loss of excessive proteins and blood cells in urine. Nephropathy may result from several factors which can damage the structural and functional component of kidneys. Gold and penicillamine are some such factors.

Gold and penicillamine nephropathy (kidney damage): Incidence, age and sex

Nephropathy due to gold and penicillamine may affect an individual at any age. However older adults are more susceptible to this disorder. There seems to be no gender predilection.

Signs and symptoms of gold and penicillamine nephropathy (kidney damage): Diagnosis

The clinical features of gold and penicillamine nephropathy arise due to structural changes in filtration units of the kidneys, resulting in functional kidney damage. Affected individuals may complain of passing blood in urine, increased frequency of urination or foamy appearance of urine. Sometimes loss of appetite, high blood pressure, and increased fatigue may also be noted. Longstanding cases of nephropathy may result in swelling in some areas of body, especially the face.

This disorder may be diagnosed by detailed history including history of previous medications. Microscopic examination of the urine shows red blood cells and proteins. Kidney biopsy may be done to establish the diagnosis of membranous nephropathy which occurs due to gold and penicillamine use.

Causes and prevention of gold and penicillamine nephropathy (kidney damage)

Such kind of nephropathy is seen in individuals who are on long-term treatment of gold or penicillamine. Both these drugs are used in patients of rheumatoid arthritis which is a severe disease. Penicillamine is also used in cases of Wilson’s disease which is characterised by deposition of excess copper in body. It is essential to regularly monitor the individual who is on gold or penicillamine therapy to prevent their adverse effects on kidneys.

Gold and penicillamine nephropathy (kidney damage): Complications

Gold and penicillamine nephropathy can severely damage kidneys and lead to end stage kidney disease. In severe and longstanding instances, the affected individual may exhibit chronic kidney failure.

Gold and penicillamine nephropathy (kidney damage): Treatment

A detailed evaluation of the individual’s condition is significant in its management. The first step is to immediately discontinue gold and penicillamine. The main aim of treatment is to prevent progression of kidney damage. Anti-hypertensives like ACE inhibitors or ARBs are prescribed to reduce the high blood pressure. Dietary changes like low salt and low protein diet are recommended. Such conservative management generally resolves the problem and improve the condition of individual. The prognosis of kidney damage depends upon its severity and differs from individual to individual. The damage to kidneys is reversible in most of the individuals. However some degree of damage may be irreversible and progress to end stage renal disease.

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