Membranoproliferative glomerulonephritis natural history, complications and prognosis

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Natural history

The natural history of Membranoproliferative glomerulonephritis (MPGN) is characterised by severity of clinical features which autonomously fluctuate, with very few cases of complete remission. Acute presentation and a slower reduction in renal function have seen more in children than adults. ESRD have been occurred among approximately 40% of patients within 10 years of diagnosis. Features suggestive of an adverse outcome include the nephrotic syndrome, renal dysfunction at onset, and persistent hypertension. Type II MPGN is associated with a worse prognosis, as is the presence of chronic interstitial damage on renal biopsy. In 20 - 30% of type I and 80 - 90 % type II MPGN, Membranoproliferative glomerulonephritis may recur.

Complication

the most common complications in patients who have MPGN are included:

• End-stage renal disease (ESRD)
• Edema
  • Periorbital
  • Dependent edema
• Hypertension
• Infection with encapsulated bacteria
  • Haemophilus species
  • Streptococcus species
  • Klebsiella species
• Thromboembolism events
  • There are several predisposing factor that can increase thromboembolism tendency, these factors are included:
    • Decrease in anticoagulant factors such as, proteins C and S and antithrombin III
    • Increased platelet aggregability
    • Increase procoagulants proteins
    • Hyperlipidemia
    • Impaired fibrinolysis
• Hyperlipidemia
• Malnutrition
• Anemia due to iron deficiency
• Hypocalcemia due to hyperparathyroidism secondary to vitamin D deficiency