Correlation Research Between Renal Pathology And Urine Podocalyxin Quantitation Of The Syndrome Pattern Of Chinese Medicine Of IgA Nephropathy

Objective:To study the clinical characteristics about children’s primary IgA nephropathy(IgAN).And the relationship between syndrome pattern of traditional Chinese medical(TCM)、renal pathology and podocalyxin quantitation in urine was analyzed in children with IgAN.According to the results,we will make a discussion with the syndrome differentiation and treatment of TCM,then provide a theoretical basis on judging the progress of the disease and improve the prognosis of children’s IgA nephropathy.Methods:128children diagnosed by the renal biopsy of IgAN were reviewed during the period of October2011to December2012from pediatrics department of Nanjing command of jingling hospital. Complete the various laboratory tests and syndrome pattern of TCM was discriminated in all children with four diagnostic methods according to the classification standards after admission. Collecting the morning urine of all children before renal biopsy to detect the quantitation of podocalyxin in urine.Using different statistical methods to analyse the correlation between TCM syndromes, clinical features, renal pathology stage and podocalyxin in urine of IgA nephropathy in children.Results:1.According to the results of TCM syndromes of IgAN:22cases were type of lung defending with wind-heat and forcing blood to descend;19cases were type of damp-heat in lower Jiao and forcing blood to descend;34cases were type of liver and renal yin deficiency;30cases of deficiency of qi in spleen and renal and23cases of deficiency of both qi and yin.2.There had positively correlation between podocalyxin in urine of IgAN with different TCM syndromes and24h protein quantitation in urine(P<0.05).3.IgAN with different TCM syndromes、clinical features、renal pathological performances and urine podocalyxin excretion displayed relatively(P<0.05). Patients of lung defending with wind-heat and forcing blood to descend type and damp-heat in lower Jiao and forcing blood to descend type showed rather milder renal pathological changes,by Lee classification,most of them belonged to grade Ⅰ～Ⅱ with the clinical manifestation of isolated hematuria,podocalyxin in urine expressed lowly;Patients of liver and renal yin deficiency、deficiency of qi in spleen and renal and deficiency of both qi and yin types had severe pathological changes and majority of them belonged to grade Ⅲ-Ⅳ, podocalyxin in urine expressed highly with hematuria and proteinuria or nephrotic syndrome as the main clinical performances;and the most severe pathological chang was shown in patients of deficiency of both qi and yin type,the Lee’s grade V was dominant in them,but the number was too little without statistically significances.Conclusions:The syndromes of Chinese medicine of IgAN in children、clinical features、renal pathological manifestations and urine podocalyxin excretion had certein relevances. Urinary podocalyxin might be a useful biomarker to detect renal pathological injury of IgAN. Macro differentiation of Chinese medicine combined with renal microscopic changes and laboratory tests of Western medicine will expand the ideas of diagnosis and treatment of children with IgAN.