<s>[INST] My wife is suffering from membranous nephropathy. She is undergoing treatment for the last one year. Urine spot protein is > 750 mg/dl and urine spot creatinine is > 100 mg/dl. Urine spot prot/Creat Ratio is > 14/1 during the last month. Still she was OK and was moving. For the last three days she has become very sick. She has severe pain in the kidney region. Whole body is paining. Not able to get up from the bed. Kindly give me guidance. [/INST] Since your wife is suffering from membranous nephropathy(MN) and her PC ratio is very high, she might also have hypoalbuminemia, a condition which can predispose to cause blood closing in her veins, especially in her renal veins. And also she is predisposed to various infections secondary to lose of immune factors in urine and also due to the immunosuppressive nature if the Chat Doctor.  The pain could be due to either of the above cause. So please consider this as an emergency she requires an ultrasound abdomen with renal vessel Doppler a complete blood count, blood culture and serum albumin and fibrinogen Asia. Also make sure that she has not skipped any  </s>