Name of the Condition

• Recurrent and Persistent Hematuria with Diffuse Membranous Glomerulonephritis
• Also known as N02.2 in the ICD categorization. It may also be referred to as diffuse membranous nephropathy in medical terms.

Summary

Recurrent and persistent hematuria with diffuse membranous glomerulonephritis is a kidney disorder characterized by frequent episodes of blood in the urine due to inflammation and damage to the kidney's filtering units, specifically affecting the membranes. This condition can lead to significant kidney dysfunction if inadequately managed.

Causes

The precise cause of diffuse membranous glomerulonephritis often remains unknown, but it may be triggered by autoimmune reactions where the body’s immune system attacks the kidneys. It can also be associated with certain infections, medications, or systemic diseases like lupus.

Risk Factors

• Age: More common in adults over the age of 40.
• Gender: Slightly more prevalent in males.
• History: Individuals with a history of autoimmune diseases.
• Infections: Exposure to infections like hepatitis B or C.
• Medication: Use of certain drugs (e.g., NSAIDs, gold therapy).

Symptoms

• Persistent or recurring blood in the urine (hematuria).
• Proteinuria (excess protein in urine).
• Edema (swelling, particularly in the legs and ankles).
• Hypertension (high blood pressure).
• Frothy or foamy urine due to excess protein.

Diagnosis

• Urinalysis: To detect blood and protein in urine.
• Blood Tests: To evaluate kidney function and screen for underlying conditions.
• Kidney Biopsy: A definitive test involving a sample of kidney tissue to confirm diagnosis and determine extent of damage.
• Imaging Tests: Such as an ultrasound to assess kidney size and structure.

Treatment Options

• Medications: Immunosuppressive drugs to reduce inflammation, ACE inhibitors, or ARBs to manage proteinuria and blood pressure.
• Dietary Management: Low-sodium and low-protein diet plans.
• Plasmapheresis: In severe cases, to remove antibodies from the blood.

Prognosis and Follow-Up

The prognosis varies; some patients achieve remission while others may progress to chronic kidney disease. Regular follow-up is critical to manage symptoms, adjust treatments, and monitor kidney function.

Complications

• Progression to chronic kidney disease or kidney failure.
• Increased risk of thromboembolic events.
• Long-term cardiovascular complications due to hypertension.

Lifestyle & Prevention

• Diet: Reduce salt and protein intake.
• Exercise: Regular but moderate exercise.
• Blood Pressure Control: Regular monitoring and maintaining a healthy range.

When to Seek Professional Help

Seek immediate medical attention if experiencing severe symptoms such as persistent blood in urine, sudden swelling, or unexplained weight gain. Prompt evaluation is crucial for managing disease progression.

Additional Resources

• National Kidney Foundation: kidney.org
• American Association of Kidney Patients: aakp.org

Tips for Medical Coders

• Ensure thorough documentation to capture the recurrent nature and specific type of glomerulonephritis.
• Double-check for associated conditions that might affect coding, such as autoimmune disorders.
• Avoid confusion with other types of hematuria or glomerulonephritis subtypes often due to overlapping symptoms.