Pathological Characteristics Of IgA Nephropathy Presented With Isolated Hematuria

Objective:To study the pathological characteristics and the relationship of hematuria and pathological changes and emphasize the importance of renal biopsy for patients with IgA nephropathy and isolated hematuria.Methods:Pathological characteristics of90patients with IgA nephropathy confirmed by renal biopsy and presented with isolated hematuria were reviewed. We analyzed their pathological features and to classify them according to Oxford Classification by using light and immunofluorescence.Results:In our study, the age of onset who was IgA nephropathy presented with isolated hematuria focus on20to30years old, and the ratio of male/female was about1:3. The focal and (or) segmental glomerulosclerosis was the most frequent diagnosis (52.22%). The distribution of hematuria focus on20-40thousands, followed by≥160thousands.46.67%Of cohort had global glomerulosclerosis which excepted the physical glomerular sclerosis,30%along with segmental sclerosis, global or segmental sclerosis accounted for58.89%, and the incidence of crescent formation was24.44%. However, the proportion of glomerular globar sclerosis and segmental sclerosis was mainly concentrated in less than5%and5%to10%respectively. The immune pathology of IgA nephropathy with isolated hematuria was mainly simple IgA deposition (43.33%). AG、AM and AGM is respectively28.89%,12.22%and15.56%. IgA fluorescence intensity distribution mainly concentrated on IgA++.46.67%of patients accompanied with complement deposition, and92.89%of which was C3deposition. According to the Oxford classification, M1S0E0T0accounted for53.33%. The incidence of M, S, E, and T was100%,30%,14.44%and22.22%.46.67%of patients included two or more pathological lesions. There were no significant correlations between hematuria levels and pathological diagnosis or the ratio of sclerosis. Conclusions:The focal and (or) segmental glomerulosclerosis played an important role in the patients of IgA nephropathy presented with isolated hematuria. The clinical manifestation and kidney pathology was inconsistent. So we suggest paying attention to renal biopsy for patients with isolated hematuria. In particularly, renal biopsy may be enforced as soon as for young patients to identify the degree of kidney injury, active treatment and delay progression of disease extremely.