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MEMBRANOPROLIFERATIVE GLOMERULONEPHRITIS (MPG)

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MEMBRANOPROLIFERATIVE GLOMERULONEPHRITIS (MPG)

Membranoproliferative glomerulonephritis is a specific type of glomerulonephritis that occurs as a result of immune deposits in the kidneys, resulting in structural changes to the glomerular capillary walls.

  • MPG is an autoimmune disorder.
  • Each kidney is made up of approximately 1 million glomeruli.
  • Glomeruli remove extra fluid, electrolytes, and waste from the bloodstream.
  • When these structures become inflamed, a condition called glomerulonephritis develops.
  • There are three forms of the disease each with different appearances on the microscope: MPGN type 1, type 11, and type 111.
  • The most common form is type 1, accounting for about 80 to 85% of all cases. In this type, immune complexes are seen in the mesangium and subendothelial space. Immune complexes are formed by the combination of antibody and antigen which bind together and get lodged in the kidney. Immune complexes must be removed from tissues and disallowed from accumulating and forming deposits throughout the body. Failure to clear this immune complexes activates the immune system, causing inflammation and damage in the kidney.
  • Type 11 is also called deposit dense disease. This type is characterized by dense ribbon-like deposits found along the basement membranes of the glomeruli, tubules, and Bowman’s capsule. This type accounts for about 15 to 20% of all cases.
  • The type 111 is rare and similar to the type 1. However, the immune complexes are found only in the subendothelial space.

CAUSES

MPG is an autoimmune disorder. An autoimmune disorder occurs when the immune system malfunctions, mistakenly attacking healthy cells.

Certain conditions that may contribute to the immune system malfunction includes:

  • Autoimmune disease such as lupus, scleroderma, Sjogren syndrome.
  • Chronic infections such as subacute bacterial endocarditis, hepatitis B and C disease, visceral abscess, ventriculoatrial shunt infection
  • Certain cancers such as leukemia, lymphoma, melanoma

SYMPTOMS

  • Blood in the urine
  • Protein in the urine (proteinuria)
  • Swelling in some body parts, noticeable around the eyes, legs, ankles, abdomen (called edema)
  • a decrease in urine volume

DIAGNOSIS AND TREATMENT

To make a diagnosis, the doctor will carry out:

Urine tests to help find protein and blood in the urine

Blood tests to help find the levels of cholesterol, proteins, and wastes in the blood.

Glomerular filtration rate to detect how well your kidney is filtering waste from your body.

If results indicate the presence of the condition, a kidney biopsy will be ordered. The result of the biopsy will enable the doctor to determine if you have type 1, 11, or 111. A kidney biopsy is the only method to confirm the diagnosis.

TREATMENT

Treatment depends on the severity of the condition. Before any treatment plan is made, the doctor will try to find the cause of your condition.

Your treatment option may be different if your condition is not caused by another disease, such as Hepatitis C.

The aim of treatment is to slow down the process of kidney failure and help you manage symptoms such as edema, proteinuria, and high blood pressure.

They may include:

  • Corticosteroids called prednisone to try and control proteinuria
  • Immunosuppressive drugs
  • Diuretics and low salt diet to help relieve edema
  • ACE inhibitors
  • Correct amounts of fluid and protein intake.

If kidney failure occurs, dialysis and kidney transplant may be recommended.