Membranoproliferative glomerulonephritis laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Jogeet Singh Sekhon, M.D. [2]


MPGN laboratory findings include urinalysis, renal function tests, complete blood counts, complement profile and other diagnostic tests for evaluating the cause of MPGN.

Laboratory Findings


  • Glomerular hematuria; characterized by dysmorphic red blood cells (RBCs) and RBC casts[1]
  • Proteinuria is almost always present.
  • Urine protein creatinine ratio is a good estimate of 24-hour urinary protein excretion.
  • Nephrotic proteinuria is present in approximately 50% of patients.

Serum chemistries

CBC with differential:

Urine analysis
Renal function tests
Complement profile
Serum ANA
  • Postive serum ANA means autoimmune disease etiology
Blood culture
  • Chronic bacterial infections
Sequence of Diagnostic Studies

The urinalysis and comprehensive chemistry panel should be performed when:[4]

  • The patient presented with signs of hypertension and proteinurea
  • Complete blood count
  • Urinaylsis
  • A positive ANA, anti dsDNA suggest the diagnosis of membranous glomerulonephritis
  • To confirm the diagnosis we do renal biopsy

Complement profile -

  • C3 levels are low in about half of the patients.
  • Evidence of activation of the classic pathway of complement (ie, low C4, C2, C1q, B, C3)
  • Terminal complement components C3, C5, C8, and C9 may be low or within the reference range.
  • NFc (C4NeF) or NFt may be present.
  • MPGN type II
  • C3 levels are low in 70-80% of patients.
  • Early and terminal complement components are within the reference range.
  • NFa (C3NeF) is present in more than 70% of patients.
  • MPGN type III
  • C3 levels are decreased in 50% of patients.
  • C1q and C4 levels are within the reference range.
  • Terminal complement components are low, especially if C3 is markedly depressed.
  • NFa is absent and NFt is present in 60-80% of patients.
  • Antistreptolysin-O (ASO) titers may be elevated in as many as 50% of patients at presentation.


  1. Sethi S, Fervenza FC (2012). "Membranoproliferative glomerulonephritis--a new look at an old entity". N Engl J Med. 366 (12): 1119–31. doi:10.1056/NEJMra1108178. PMID 22435371.
  2. Rennke HG (1995). "Secondary membranoproliferative glomerulonephritis". Kidney Int. 47 (2): 643–56. PMID 7723253.
  3. Bourke E, Campbell WG, Piper M, Check IJ (1989). "Hypocomplementemic proliferative glomerulonephritis with C3 nephritic-factor-like activity in multiple myeloma". Nephron. 52 (3): 231–7. doi:10.1159/000185648. PMID 2662048.
  4. Qin W, Beck LH, Zeng C, Chen Z, Li S, Zuo K, Salant DJ, Liu Z (June 2011). "Anti-phospholipase A2 receptor antibody in membranous nephropathy". J. Am. Soc. Nephrol. 22 (6): 1137–43. doi:10.1681/ASN.2010090967. PMC 3103733. PMID 21566055.
  5. Alpers CE, Smith KD (2008). "Cryoglobulinemia and renal disease". Curr Opin Nephrol Hypertens. 17 (3): 243–9. doi:10.1097/MNH.0b013e3282f8afe2. PMID 18408474.

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