Membranoproliferative glomerulonephritis (GN) type II is a kidney disorder causing decreased kidney function because of inflammation and changes in the tissues of the internal kidney structures.
Membranoproliferative glomerulonephritis (type II); Glomerulonephritis - membranoproliferative (type II); Mesangiocapillary glomerulonephritis (type II); Dense deposit disease; MPGN II
Causes, incidence, and risk factors:
Glomerulonephritis is inflammation of the glomeruli, the inner structures of the kidney that help filter waste and fluids from the blood to form urine.
Membranoproliferative GN II is a form of glomerulonephritis. It is 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 waste and extra fluid from the blood.
The changes in this membrane lead disrupt the body's ability to filter urine. Protein and fluid leak out of the blood vessels into body tissues, leading to edema . Nitrogen waste products may accumulate in the blood (azotemia ) because of poor kidney functioning.
Membranoproliferative GN II is much less common than Membranoproliferative GN I and occurs in both males and females, usually under age 30. It also tends to get worse faster than does membranoproliferative GN I.
The disorder is often progressive and may result in chronic renal failure .
Signs and tests:
The results of a physical examination vary depending on the symptoms. Swelling may be present along with 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 and increased production of renin , a hormone that controls blood pressure.
Membranoproliferative GN II may present in several forms. It may be seen as acute nephritic syndrome , nephrotic syndrome , or an abnormal urinalysis without symptoms. Urine output decreases. Swelling may occur as sodium and water are retained in the body.
These tests help confirm the diagnosis:
A kidney biopsy confirms the diagnosis of membranoproliferative GN II.
Treatment varies according to the symptoms. The goals of treatment are to reduce symptoms, prevent complications, and slow the worsening of the disorder.
Dietary adjustments may include restrictions on sodium, fluids, protein, or other restrictions to control high blood pressure, swelling, and accumulation of waste products in the bloodstream.
Medicines used to treat this condition and symptoms may include:
- Blood pressure medications
Dialysis or kidney transplantation may eventually be needed to manage renal failure .
The disorder progresses slowly to chronic renal failure . Fifty percent of cases will develop chronic renal failure within 10 years.
Calling your health care provider:
Call for an appointment with your health care provider if symptoms indicate MPGN II.
Call for an appointment with your health care provider if symptoms worsen or new symptoms develop, including decreased urine output .
Prevention is often not possible.