Analysis Of Risk Factors For Renal Pathological Staging In Patients With Idiopathic Membranous Nephropathy

Objective:To explore the risk factors for the severity of renal pathological staging in patients with idiopathic membranous nephropathy(IMN),and to further analyze the risk factors for the severity of renal pathological staging of IMN in different genders and ages.Methods:A total of 571 patients with idiopathic membranous nephropathy who underwent renal biopsy for the first time in our hospital from January 2016 to December 2020 were retrospectively included.According to the results of renal biopsy,they were divided into stage I IMN group,Ⅰ-Ⅱ stage IMN group,Ⅱ stage IMN group,Ⅱ-Ⅲ stage IMN group and Ⅲ stage IMN group 5 groups,the clinical indicators were collected and compared.They were then divided into male group and female group according to gender,and divided into ≤44-year-old group,45-59-year-old group,and ≥60-year-old group according to age,to explore the clinical indicators affecting the severity of pathological staging.Results:(1).Serum cystatin C,serum creatinine,blood urea nitrogen,and 24-hour urine protein were compared between groups,and the difference was statistically significant(P<0.05).The results of multiple ordinal logistic regression analysis showed that serum cystatin C was an independent risk factor for the severity of the pathological stage of IMN(P<0.05).(2)The serum cystatin C,serum creatinine,and 24-hour urine protein in the male group were compared between the groups,and the difference was statistically significant(P<0.05).Multiple ordinal Logistic regression analysis showed that serum cystatin C and24-hour urine protein were independent risk factors for the severity of the pathological stage of male IMN(P<0.05).The serum cystatin C and serum creatinine of the female group were compared between the groups,and the difference was statistically significant(P<0.05).No independent risk factors for the severity of female IMN pathological stage were found(P<0.05).(3)Smoking history,drinking history,hypertension history,diabetes history,serum cystatin C,serum creatinine,blood urea nitrogen,uric acid,serum albumin,total cholesterol,triglyceride,low-density lipoprotein,24-hour urine protein in IMN patients aged ≤ 44 years were compared between groups,the difference was not statistically significant(P<0.05).The serum cystatin C,serum creatinine,blood urea nitrogen and24-hour urine protein of IMN patients aged 45-59 years were compared between groups,and the difference was statistically significant(P<0.05).Multivariate ordinal Logistic regression analysis showed that serum cystatin C and 24-hour urine protein were independent risk factors for the severity of pathological staging of IMN aged 45-59 years(P<0.05).The serum cystatin C of IMN patients aged ≥60 years was compared between the groups,and the difference was statistically significant(P<0.05).The results of multiple ordinal Logistic regression analysis showed that serum cystatin C was an independent risk factor for the severity of the pathological stage of IMN ≥60 years old(P<0.05).Conclusion:(1).Serum cystatin C is an independent risk factor for the severity of renal pathological staging in IMN.(2).Serum cystatin C and 24-hour urine protein were independent risk factors for the severity of renal pathological staging in male IMN.(3).Serum cystatin C and 24-hour urine protein were independent risk factors for the severity of renal pathological staging in 45-59 years old,and serum cystatin C was an independent risk factor for the severity of renal pathological staging in IMN ≥60 years old.