Membranoproliferative glomerulonephritis

  • Definition
    • Membranoproliferative glomerulonephritis is a kidney disorder that involves inflammation and changes to kidney cells. It may lead to kidney failure.

  • Alternative Names
    • Membranoproliferative GN I; Membranoproliferative GN II; Mesangiocapillary glomerulonephritis; Membranoproliferative glomerulonephritis; Lobular GN; Glomerulonephritis - membranoproliferative; MPGN type I; MPGN type II

  • Causes
    • Glomerulonephritis is an inflammation of the glomeruli. The glomeruli of the kidney help filter wastes and fluids from the blood to form urine.

      Membranoproliferative glomerulonephritis (MPGN) is a form of glomerulonephritis caused by an abnormal immune response. Deposits of antibodies build up in a part of the kidneys called the glomerular basement membrane. This membrane helps filter wastes and extra fluids from the blood.

      Damage to this membrane affects the kidney's ability to create urine normally. It may allow blood and protein to leak into the urine. If enough protein leaks into the urine, fluid may leak out of the blood vessels into body tissues, leading to swelling (edema). Nitrogen waste products may also build up in the blood (azotemia).

      The 2 forms of this disease are MPGN I and MPGN II.

      Most people with the disease have type I. MPGN II is much less common. It also tends to get worse faster than MPGN I.

      Causes of MPGN may include:

  • Symptoms
  • Exams and Tests
    • The health care provider will examine you and ask about your symptoms. The provider may find that you have signs of too much fluid in the body, such as:

      • Swelling, often in the legs
      • Abnormal sounds when listening to your heart and lungs with a stethoscope
      • You may have high blood pressure

      The following tests help confirm the diagnosis:

  • Treatment
    • Treatment depends on the symptoms. The goals of treatment are to reduce symptoms, prevent complications, and slow the progression of the disorder.

      You may need a change in diet. This may include limiting salt, fluids, or protein to help control high blood pressure, swelling, and the buildup of waste products in the blood.

      Medicines that may be prescribed include:

      • Blood pressure medicines
      • Dipyridamole, with or without aspirin
      • Diuretics
      • Medicines to suppress the immune system, such as cyclophosphamide
      • Steroids

      Treatment is more effective in children than in adults. Dialysis or kidney transplant may eventually be needed to manage kidney failure.

  • Outlook (Prognosis)
    • The disorder often slowly gets worse and eventually results in chronic kidney failure.

      Half of people with this condition develop chronic kidney failure within 10 years. This is more likely in those who have higher levels of protein in their urine.

  • Possible Complications
  • When to Contact a Medical Professional
    • Call for an appointment with your provider if:

      • You have symptoms of this condition
      • Your symptoms get worse or do not go away
      • You develop new symptoms, including decreased urine output
  • Prevention
    • Preventing infections such as hepatitis or managing diseases such as lupus may help prevent MPGN.

  • References
    • Schena FP, Alpers CE. Membranoproliferative glomerulonephritis and cryoglobulinemic glomerulonephritis. In: Johnson RJ, Feehally J, Floege J, eds. Comprehensive Clinical Nephrology. 5th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 21.