The Analysis Of The Clinical And Pathological Features And Risk Factors In 211 Patients With IgA Nephropathy

Objective:To investigated the relationship between clinical and pathological changes of 211 patients with IgA nephropathy in order to provide clues for clinical treatment and prediction of prognosisMethods:A positive diagnosis of primary IgA nephropathy was made after renal biopsies in 211 patients in the General Hospital of Shen-yang Military Region from May 2005 to July 2009. We retrospectively analyzed the clinical and pathological features. According to the features of urine examination, the patients with IgA nephropathy had been divided into four groups:gross hematuria,microscopic hematuria,microscopic hematuria with proteinuria and proteinuria.Diagnostic criteria were based on the 1995 WHO classification of primary glomerular diseases.Results:According to our information,the ratio of men to women was1.86:1,mean age 31.4±9.97, people of fifty and above account for about 7.1%,the incidence of gross hematuria were 38.3%, morbidity of gross hematuria in people aged forty and above were 3.7%, maximum age was sixty years old, incidence of microscopic hematuria was just 7.5%, incidence of microscopic hematuria with proteinuria was 45.9%, incidence of proteinuria was 8.0%.Mucosal infection in initiating this disease was obviously(9.4%), including tonsillitis history accounting for 7.1%, respiratory tract infection accounting for 33.1%.29.8%percent of patients arise hypertension,14.2%of patients with renal function damage,acute renal function damage was 2.8%, chronic renal function damage was11.3%, There was high morbidity of edema, hypertension and renal damage in group of microscopic hematuria with proteinuria. incidence of edema was 11.1%, incidence of hypertension account for 17.9%, morbidity of renal function damage was 7.2%.TypeIIIwas the most common one in nephropathy histological Grading,accounting for 63.1%. The score of glomerular pathological damage, severity of mesangial, proliferation, global sclerosis points, vascular disease were the highest in proteinuria group(P<0.05). Multivariate Logistic Rregression analysis showed that cholesterol and hypertension were risk factors in group of proteinuria (OR=36.000, OR=41.333,95%CI:1.772-731.562,3.423-499.146). Heavy urine protein level were the important prognosis factors which affected the patients of microscopic hematuria with proteinuria by Multivariate Logistic Regression analysis (OR5.119,95%CI:1.458-17.977).Albumin was a favorable factor for renal pathologic lesion (OR=0.06,95%CI:0.000-0.781.Conclusion:IgA nephropathy always had been found in young men, the trends in average age in groups of hematuria with proteinuria is bigger than the other groups.Pathological analysis showed that TypeⅢnephropathy was the most common type.Deposition of IgA and IgG and IgM in glomeruli was also the most type.The severity of glomerular lesion was significantly correlated with clinical mani-festations. The patients of proteinuria and hematuria with proteinuria may suggest heavy clinical and pathological changes. Cholesterol and hypertension were risk factors in group of proteinuria.Heavy urine protein were the important prognosis factors which affected the patients of microscopic hematuria with proteinuria.Albumin was a favorable factor for renal pathologic lesion.