Membranoproliferative glomerulonephritis (type 2)
Overview
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.
Symptoms
* Blood in the urine * Dark urine (smoke, cola, or tea colored) * Cloudy urine * Decrease in urine volume * Swelling of any part of the body * Changes in mental status such as decreased alertness or decreased concentration
Causes
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.
Prevention
Prevention is often not possible.
Diagnosis
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: * Urinalysis * Urine protein * BUN and creatinine * Serum complement levels * Serum complement C3 nephritic factor A kidney biopsy confirms the diagnosis of membranoproliferative GN II.
Treatment
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 * Diuretics Dialysis or kidney transplantation may eventually be needed to manage renal failure.