Membranoproliferative Glomerulonephritis (MPGN)
What is membranoproliferative glomerulonephritis (MPGN)?
Membranoproliferative glomerulonephritis (MPGN) is a kidney disorder that involves inflammation and changes to kidney cells. It may lead to kidney failure. MPGN is a specific type of glomerular disease that occurs when the body’s immune system functions abnormally. The immune system, which is responsible for fighting disease, begins to attack healthy cells in the kidney, destroying the function of the filtering units of the kidney. There are 3 different sub-types of MPGN:- Type I is characterized by immune complex deposits found in the mesangium and subendothelial space. Immune complexes are combinations of antigens and antibodies which bind to each other and then become lodged in the capillary of the kidney. These immune complexes activate the immune system causing inflammation and eventual damage to the kidney.
- Type II, also called dense deposit disease, is characterized by flowing, dense, ribbon-like deposits found along the basement membrane, tubules, and Bowman’s capsule. Type II has no known association with immune complexes.
- Type III is characterized by immune complexes found deposited in the subepithelial space. There are also large open areas in the glomerular basement membrane.
What are the symptoms of membranoproliferative glomerulonephritis (MPGN)?
Symptoms of MPGN include the following:- Blood in the urine
- Changes in mental status such as decreased alertness or decreased concentration
- Cloudy, foamy, and/or dark urine
- Decrease in urine volume
- Swelling of any part of the body
What causes membranoproliferative glomerulonephritis (MPGN)?
In MPGN, the immune system starts to attack the healthy cells in the kidneys, which in turn damage the glomeruli. The immune system produces antibodies to attack harmful substances in the body called antigens. Antigens combine with antibodies to make immune complexes. These immune complexes get stuck in the kidneys and cause damage. Causes of this immune response may include:- Autoimmune diseases (systemic lupus erythematosus, scleroderma, Sjögren syndrome, sarcoidosis)
- Cancer (leukemia, lymphoma)
- Infections (hepatitis B, hepatitis C, endocarditis, malaria)
How is membranoproliferative glomerulonephritis (MPGN) diagnosed?
The following tests help confirm a MPGN diagnosis:- BUN and creatinine blood test
- Blood complement levels
- Urinalysis
- Urine protein
- Kidney biopsy
- Genetic testing
What are the treatments for membranoproliferative glomerulonephritis (MPGN)?
The goal of MPGN treatment is to reduce symptoms, prevent complications, and slow the progression of the disorder. Thus, treatment options include:- Blood pressure medicines
- Dipyridamole, with or without aspirin
- Diuretics
- Medicines to suppress the immune system, such as cyclophosphamide
- Steroids
