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Immune Complex Membranoproliferative Glomerulonephritis (IC-MPGN)
Immune Complex Membranoproliferative Glomerulonephritis (IC-MPGN or MPGN) is a disease that causes inflammation and injury to the glomeruli. The glomeruli are tiny filtering units in the kidneys that help remove toxins from the blood.
MPGN happens when antibodies and antigens form “immune complexes” that activate part of the immune system called “the complement system” and starts attacking healthy kidney cells. The disease affects the kidney’s ability to make urine and can cause protein and blood to leak into the urine. Advanced MPGN can lead to kidney failure.
Medically reviewed by Dr. Corey Cavanaugh, D.O.
Who Gets MPGN
People of all ages can develop MPGN. Most instances of MPGN are caused by other diseases and disorders, including:
- Autoimmune diseases such as systemic lupus erythematosus
- Chronic infections such as hepatitis B or hepatitis C
- Hereditary disorders
- Monoclonal immunoglobin deposition diseases
The cause of MPGN cannot be identified in rare instances. This type of MPGN is called primary or idiopathic MPGN, is very rare. It affects about one to two people per million. Primary MPGN is most common in younger people ages 8 to 30.
Signs and Symptoms
Not everyone with MPGN has symptoms, especially in the early stages of the disease.
Signs and symptoms of MPGN include:
- Cloudy, dark or foamy urine
- Decreased urine volume
- Difficulty focusing and staying alert
- Fluid build-up (edema) that causes swelling in areas such as the hands, ankles and around the eyes
- High blood pressure
Diagnosing MPGN
Testing is the first step if your doctor thinks you may have MPGN. Initial testing can include:
- A glomerular filtration rate (GFR) calculation to estimate your kidney function. You can calculate your GFR if you know your blood creatinine and urine protein levels.
- A urine test to reveal the presence of blood or protein in your urine
If test results suggest you may have MPGN, your doctor will order a kidney biopsy. A biopsy is the only way to be sure that you have MPGN. The procedure involves removing a tiny portion of the kidney tissue and testing it in the lab.
Once your care team confirms the diagnosis of MPGN, your doctor may order additional tests. The results can help guide treatment and may include:
- Advanced complement system testing
- Blood tests to find out whether you have an autoimmune disease or infections
- Genetic testing to see if you have an inherited form of MPGN
Your Treatment Options
Treatment depends on the underlying cause of MPGN. When caused by another condition, MPGN usually goes away if the other disease responds well to treatment.
There is no cure for primary MPGN. Treatment focuses on slowing the kidney damage. Your doctor may prescribe several therapies to help manage your symptoms.
- Corticosteroids and other medicines, such as mycophenolate mofetil and rituximab, to help reduce your immune system response
- Medicines such as ACE inhibitors (angiotensin-converting enzymes) and ARB (angiotensin receptor blockers) can reduce protein loss and help manage your blood pressure
- Participation in a clinical trial
Clinical trials are another treatment option.
Your doctor helps you find the right study for you. These trials test more targeted treatments with potentially lower risks of side effects.
Some clinical trials enroll patients, based on their genetic testing results, to test the effectiveness of precision-based therapies targeted to specific genetic changes.
Tips For Living With MPGN
Your care team can help you manage your condition.
Prevent Infections
Your doctor can help you learn how to lower your risk and recognize early signs of an infection.
Medicine
Follow your doctor’s instructions and take your medicines as prescribed.
Work With Your Care Team
See your nephrologist routinely for tests and to learn more about how to manage your health.
Your Nephrologist May Also Recommend
1
Diuretics
Diuretics help manage fluid retention and edema, common complications of MPGN.
2
Anticoagulants
Anticoagulants are essential for people with rare kidney diseases. They prevent the formation of blood clots.
3
Medications
Blood pressure medicines help lower your blood pressure. Statin medicines can reduce your cholesterol level.
4
Vitamins
Vitamins are crucial in supporting overall health and lowering the risk of complications.
Kidney Transplant and MPGN
Kidney transplantation is an option for people who develop kidney failure due to MPGN. After the transplant, doctors use a transplant kidney biopsy to check whether the disease has returned. About 15% of people with MPGN develop recurrent MPGN within five years of their transplant.
