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Membranoproliferative GN

Definition

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

Alternative Names

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

Causes, incidence, and risk factors

Glomerulonephritis is inflammation of the glomeruli. These structures of the kidney help filter wastes and fluids from the blood to form urine.

Membranoproliferative GN 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 fluid from the blood.

Damage to this membrane affects the body's ability to create urine normally. It may allow blood and protein to leak 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).

There are two forms of membranoproliferative GN:

  • Membranoproliferative GN I
  • Membranoproliferative GN II

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

Many cases of membranoproliferative GN are due to causes such as:

The conditions mostly affect people ages 8 to 16.

Symptoms

Signs and tests

The results of a physical examination depend on the symptoms. There may be swelling (usually in the legs), along with other signs of fluid overload, such as abnormal sounds when listening to the heart and lungs with a stethoscope.

Blood pressure is often high because of increased water and sodium (salt) retention and increased production of renin, a hormone that controls blood pressure.

Membranoproliferative GN may be seen as:

The following tests help confirm the diagnosis:

A kidney biopsy confirms the diagnosis of membranoproliferative GN I or II.

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 medications
  • Dipyridamole, with or without aspirin
  • Diuretics
  • Medications 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.

Expectations (prognosis)

The disorder often slowly gets worse and eventually results in chronic kidney failure. Fifty percent of patients with this condition develop chronic kidney failure within 10 years.

Complications

Calling your health care provider

Call for an appointment with your health care 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

Prevention is often not possible.

References

Appel GB. Glomerular disorders and nephrotic syndromes. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 122.

Nachman PH, Jennette JC, Falk RJ. Primary glomerular disease. In: Brenner BM, ed. Brenner and Rector's the Kidney. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 30.


Review Date: 9/19/2011
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Herbert Y Lin, MD, PhD, Nephrologist, Massachusetts General Hospital; Associate Professor of Medicine, Harvard Medical School. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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