The symptoms that a patient can experience are similar across this group of conditions. Where a specific symptom is related to a particular diagnosis it is explained below.
Blood and protein in the urine
This is often one of the earliest signs of these conditions. Patients usually have no other symptoms at this stage. Sometimes there are small amounts of blood in the urine that go unnoticed by a patient. This is detected on a stick test of the urine, or by looking at the urine under a microscope (microscopic haematuria). If there is a large amount of blood, it often becomes visible. Patients notice that the urine has a smoky, rusty brown appearance rather than the clear golden colour of healthy urine. Sometimes the urine will be obviously red. If a patient develops a cough or a cold their urine often has more blood in it for a few days. In these diseases there is no pain associated with passing blood in the urine. Also the amount of blood in the urine does not relate to the severity of the disease. More is not necessarily worse.
Protein dissolved in the urine is not visible. If there a lot of protein the urine may become frothy, rather like the head on a pint of beer. Healthy urine contains hardly any protein. In these conditions the kidneys leak protein. Sometimes the leak is mild or modest, sometimes massive. A simple urine stick test can tell which. The amount of protein in the urine is an indicator of how aggressive the disease is. If the level of protein in the urine returns to normal it is a sign of improvement. Some patients have massive losses of protein that can cause facial and ankle swelling (Nephrotic Syndrome).
Swollen face and legs
Patients with this group of conditions may experience swelling of the face, especially around the eyes and eye lids. This is worse first thing in the morning and tends to improve as the day goes on. This is not an allergy. The skin is a normal colour and there is no itching or pain. There may be swollen ankles too, and this is more obvious at the end of the day. The symptom is caused by the kidneys retaining water in the body.
Rarely the swelling is because the kidneys have shut down their workload abruptly and are unable to get rid of surplus water. This sudden event may indicate a flare up of the condition, perhaps triggered by an infection. Occasionally this is the first symptom. Swelling is more often due to the nephrotic syndrome. About half of MPGN and DDD patients experience this at some point in the course of their illness.
High blood pressure is common in all these conditions. Untreated or unrecognised it further damages the kidneys.
Mild or moderate anaemia is common in MPGN at any stage.
People with MPGN may also experience hives (urticaria). These are itchy red lumpy patches under the skin that come and go over several hours or a few days .
Some patients with DDD lose fat in the face and upper part of the body (partial lipodystrophy). This changes their appearance slowly over several years. Often it is only noticed when their facial appearance is compared to old photographs. The skin itself is normal.
These conditions tend to progress slowly and decline in kidney function occurs late. A few people seem to have a spontaneous remission. Sudden deterioration of kidney function can happen, perhaps triggered by an infection, but is rare and often reversible. In most patients with MPGN and DDD the disease remains active. About half of them will progress to end-stage kidney failure over 10 years. The time over which C3G progresses is variable.
Patients do not get symptoms from low kidney function until it reaches Chronic Kidney Disease (CKD) stage 4. At this point they may develop anaemia and there is a risk of developing weakness in bones. These are both treatable and preventable (see below). If the kidney function continues to fall, tiredness, poor appetite, nausea, sickness and weight loss are possible symptoms. At this point (CKD stage 4-5) plans for dialysis and or transplantation are needed.