Clinicopathological Analysis Of Idiopathic Membranous Nephropathy In Different Age Groups In Liaoning China

Objective: To analyze the clinicopathological features and prognosis of patients with idiopathic membranous nephropathy at different ages in Liaoning China.Methods: Retrospectively study the patients with IMN diagnosed by renal biopsy at the Shengjing Hospital affiliated to China Medical University from January 2012 to December 2016,with exclusion of secondary factors,and follow-up time ≥ 1 year,according to age Divided into adolescent group,middle-aged group,and elderly group,and collected relevant clinical and pathological datas for statistical analysis.Results: A total of 444 subjects are obtained,with a male to female ratio of 1.49:1,of which 87 are in the adolescent group,263 in the middle-aged group,and 94 in the elderly group.The proportion of hypertension and diabetes in the three groups increased with age,and the difference is statistically significant(P<0.001,P=0.038).At the time of admission,the levels of hemoglobin,hematocrit,platelet and plasma albumin in the adolescent group are high,and there are significant differences(P<0.001,P<0.001,P=0.003,P<0.001),serum urea nitrogen,serum creatinine,Cys-C was low,eGFR is high,and the difference is statistically significant(P<0.001,P<0.001,P<0.001,P<0.001).Plasma fibrinogen and D-dimer levels are high in the elderly group,and the difference is statistically significant(P=0.007,P<0.001).There are no statistical differences among the rest clinical datas like 24 h urine protein,microscopic hematuria,uric acid,and so on.Pathological features: stage: The pathological stage of the three groups is mainly stage II membranous nephropathy.Light microscopy: The elderly patients has the highest proportion of glomerular sclerosis、renal tubule atrophy、renal interstitial fibrosis,、renal interstitial cell infiltration,、arteriolar hyaline degeneration、and wall thickening,the differences are statistically significant(P < 0.001,P < 0.001,P = 0.002,P < 0.001,P = 0.003,P < 0.001).At the end of follow-up,no matter which kind of treatment,the youth group is more effective than the other two.Conclusion: The clinical and pathological manifestations of adolescent IMN patients are mild and the prognosis is relatively good.The incidence of hypertension and diabetes in the elderly patients with IMN is relatively high,the renal function is relatively poor,the coagulation index is abnormal,the pathological manifestation is heavy,and the prognosis is poor,which disease progresses rapidly and is easier to enter the end stage of the kidney.