A type of glomerulonephritis, known as diffuse proliferative glomerulonephritis (DPGN) is a group of kidney disorder marked by inflammation of the glomeruli, the small blood arteries in the kidneys that oversees removing waste and extra fluid from the circulation. 
In DPGN the glomeruli of both kidneys normally have the increased inflammatory cells and proliferated cells (cells that multiply). This proliferation results in the formation of the immune complex within the glomerulus causing impairment of kidney function and the leakage of blood and protein into the urine, which is a common state known as proteinuria. 
Different etiologies, including systemic lupus erythematosus as an example of autoimmune disorders, infection such as streptococcal ones and some medications may be responsible in some cases. 

DPGN affects nearby 30-60% of SLE patients and the female who are mostly of childbearing age. DPGN which origins from such systemic diseases as MPGN, IgA nephropathy and it differs in certain regions of the world from others. Social factors such as unhealthy practices and prevalence of determined diseases might affect DPGN rates differently around the world.  
Research findings indicate that 8.6% of individuals diagnosed with lupus nephritis experienced mortality, while a substantial 95% achieved a mean survival rate of five years post-diagnosis. 

In DPGN, antigen-antibody complexes are accumulated in glomeruli, which activates inflammation. It results in the activation of complement system and those cells like neutrophils and macrophages brought with inflammation. Endothelium cell proliferation lead to expansion of broken glomeruli. White blood cells also come and accumulate in the areas of inflammation, releasing the cytokines, which with time continue to damage the body. Impaired endothelium is the reason of the filtration disorder, so proteins are leaking out from the kidney. Chronic inflammation causes thickening of the glomerular basement membrane which further walls structure functionality. 

Immune Complex Deposition: Immune complexes, formed by the joining of antibodies and antigens, are the cause of deposition into the glomerulus. 
Infections: The individuals can have various infections, particularly bacterial infections such as streptococcus group infection (streptococcal throat infection) which can stimulate immune response that entails formation and deposition of immune complex in kidney region leading to the development of progressive decline of kidney. 
Systemic Diseases: It was found that one of the systemic diseases, such as systemic lupus erythematosus (SLE) can be presented with the DPGN development.  
Genetic Factors: Genetic factor is one of those predisposed aspects which have a lead role in DPGN. It is possible that some of the hereditary traits will influence the immune system of the concerned persons or the inheriting of the diseases that increase the risk of DPGN. 

The prognosis for DPGN is affected by additional medical disorders, such as diabetes or hypertension, which must be managed. The prognosis is worse, and complications are more likely to occur in older people. Prognosis for DPGN is poorer in cases with high serum creatinine upon diagnosis. A higher protein level in the urine indicates serious kidney injury and a worse prognosis. 

Age group 

DPGN can manifest for people at any stage of life such as children, adolescents, and adults. It will frequently take place as a primary renal disease or as a secondary disease because of other disorders like systemic lupus erythematosus or infections (secondary). 

Hypertension assessment 

Pulmonary Edema 

Peripheral neuropathy 

Skin assessment 

Abdominal tenderness 

Lymphadenopathy 

Systemic Lupus Erythematosus  

Viral Infections 

Other Autoimmune Diseases 

Genetic Factors 

Environmental Factors 

Hypertension 

Obesity 

Hematuria: Blood in the urine is a common sign of hematuria which is a common characteristic of this disorder.  
Proteinuria: Protein found in the urine, it’s a key factor too. Proteinuria may be found in a very mild levels or in its most severe level. 
Hypertension: Chronic High blood pressure is commonly observed from damaged kidneys that do not effectively control fluids and electrolytes within the body. 
Edema: Condition, such as puffiness around or under the eyes, hands, feet, and/or ankles due as a result of the retention of water within the body tissues. 
Fatigue and malaise: Generalized feeling of weakness and fatigue is common. 

 Immunosuppressive Therapy: Usually, immunosuppressive medications serve as the main option for DPGN. These medications can work by focussing on reducing excessive immune system activity that results in the inflammation of the kidneys. 
 
Blood Pressure Management: Medications like ACE inhibitors or angiotensin II receptor blockers (ARBs) must be considered and blood pressure should be carefully monitored and controlled particularly by using them. 
 
Dietary Modifications: People with DPGN may improve the quality of life by maintaining a healthy diet and avoid an excessive load on the kidneys to fight off the symptom. 
 
Regular Monitoring: The patients with DPGN need to be monitored with the regular blood pressure test, kidney function test and protein in the urine and other close parameters.

Supportive Therapies: Moreover, certain capillary conditions can lead to kidney failure and require dialysis or kidney transplantation in the case of ESRD. 

Nephrology

Check salt consumption for regulating high blood pressure and water retention low.

Consume a moderate level of proteins in meal to prevent kidney problems.

Monitor for potassium and phosphorus level when required. 

Test the need for extra water or juices according to the doctor’s recommendation.

To overcome this condition avoid self-prescribed medications, which includes immunosuppressants and corticosteroids.

Test the kidney function at least on a regular basis, ensuring proper development of the organ.

Maintain your weight within normal levels through healthy eating and exercising.
Maintain cleanliness and prevent infections. 

Nephrology

Prednisone: Corticosteroids, such as prednisone, are potent anti-inflammatory drugs that can help suppress the immune response and reduce inflammation in the kidneys. In DPGN, corticosteroids may be used to reduce the inflammation and swelling in the kidneys. 

Nephrology

Cyclophosphamide: The drug suppresses the immune system by interfering with the growth of certain cells, including those involved in the inflammatory response.  

<b>Mycophenolate mofetil: It functions by preventing T and B cells, which are important for the immunological response, from proliferating. 

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Azathioprine: Azathioprine functions by inhibiting the immune system’s activity thereby mitigating inflammation and kidney damage in conditions such as DPGN. 

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Rituximab: Rituximab, a monoclonal antibody that targets the CD20 antigen on B cells, to treat different types of glomerulonephritis, such as diffuse proliferative glomerulonephritis, has been studied. 

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Kidney transplant: When dialysis and medication are not sufficient to protect kidney in that case, kidney transplant surgery is done to save the patient’s life. 

Nephrology

To validate the diagnosis of DPGN, conduct a thorough clinical evaluation, tests and imaging. 
 
Begin treatment immediately to prevent further inflammation and to manage the symptoms. 
 
Track and readjust treatment based on reaction and adverse effects. 
 
Mitigate issues such as hypertension and renal failure. 
 
Continue constant therapy to prevent relapses and keep the renal function as normal as possible. 
 
Instruction patients about the disease, the treatment, and the lifestyle changes. 
 
Organize periodic health checks and tweak the treatment to progress accordingly.