Analysis Of Clinical And Pathological Characteristics In153Caseswith IgA Nephropathy

Objective：Analyze the clinical features, pathological characteristics and laboratoryresults of153cases of IgA nephropathy which are diagnosed in the first hospitalof Jilin University Bethune Department， and summarize the relevance andpathogenesis regularity in order to provide a basical treatment guidance and judgingprognosis.Methods：Analyze the153cases of patients with IgA nephropathy in the firsthospital of Jilin University Bethune Department from sep2010to sep2013retrospectively. The secondary renal damage caused by allergic purpura, systemiclupus erythematosus, viral hepatitis, tumor, ankylosing spondylitis, rheumatoidarthritis, little vasculitis associated ANCA and other systemic diseases are excluded.Analyze the clinical and pathological characteristics and interdependency.Results:1. General situation:153cases of IgA nephropathy patients, including84malecases and69female cases.87patients came from city with the average age of38.84±13.57years.66patients were from rural areas with the average age of31.97±11.01years. The age distribution of urban patients and rura patients had significantdifference (P=0.001), maximum at50years of age or older.2. Clinical characteristics: The onset age of the naked eye hematuria in patientswith IgA nephropathy was younger than that of patients with renal insufficiency,proteinuria and hypertension, with statistically significant differences(P<0.05). As theincrease of age, the incidence of hypertension increased significantly (x2=23.153,P=0.000) and there was no statistical difference between the age, renal insufficiency,hypertriglyceridemia and hypercholesterolemia (P>0.05). The patients with IgAnephropathy, who excret large amounts of protein in the urine, were more susceptibleto renal insufficiency (x2=6.137, P=0.013). As the CKD stage progresses, theproportion of IgAN patients with abnormal proteinuria or with high blood pressure increased, but the proportion of patients with the naked eye hematuria reduced. Thedifferences are of statistical significance.3. Pathological characteristics：With the progress of pathological grade, theproportion of patients with CKD stage4or greater increased, these values havestatistical significance (x2=56.435, P<0.01). The average age of pathological gradehad no statistical difference (P>0.05); there was no significant difference among thegrades sex of different pathological(x2=1.019, P=0.732); With the progress ofpathological grading, the rate of renal insufficiency(x2=34.551, P<0.01) andanemiawas (x2=20.800, P<0.01) increased. The main form of immune globulin inpatients with IgA nephropathy was IgA+IgM+C3and the percentageof IgA+IgM+C3increased with the pathological grading, these values havestatistical significance (x2=9.943, P=0.041).Conclusion: The quality of urban patients with IgA nephropathy are more thanrural patients,especially50years old and older. The risk of hypertension wasincreased as the patients with IgA nephropathy grew older. And the risk of renaldysfunction was increased as the24hour urinary protein quantitative increased. Withthe CKD staging, the proportion of patients with massive proteinuria increased, whilethe proportion of patients with naked eye hematuria reduced. Pathologic classificationof IgA nephropathy mainly based on Lee’s III class; With the progress of pathologicalgrade, the proportion of patients with CKD stage4or greater increased, the rate ofrenal failure was increased and the incidence of anemia increased significantly. Themain form of immune globulin deposition in patients with IgA nephropathy wasIgA+IgM+C3.With the progress of the pathology of patients with IgA nephropathy,thepercentage of IgA+IgM+C3is increased.