PROGNOSIS

Outcomes in idiopathic disease are poor. More than 60% of patients with type I MPGN will progress to ESRD within 10 years of diagnosis. For DDD, the picture is even more grim, with ESRD usually occurring within 4 years of diagnosis. In all MPGN types, signs that portend a poorer prognosis include nephrotic syndrome, reduced GFR, and advanced tubulointerstitial disease. Complement levels do not correlate well with prognosis.

For patients who reach ESRD, renal transplant may be performed, but recurrence in the allograft is common unless the underlying cause has been addressed. MPGN type I has been documented to recur in 30% to 77% of allografts, leading to graft loss in 17% to 50% of cases. For DDD the prognosis is even worse, with virtually all transplanted patients experiencing recurrence and at least half eventually losing the graft as a result.