Research Of The Dinical And Pathologic Factors Of Pediatric IgA Nephropathy

Research background:IgA nephropathy is one of the common glomerular disease in childhood. Renal biopsy immune pathological examination showed glomerular mesangial area is given priority to IgA sample particle deposition. With recurrent gross hematuria or the microscopic hematuria as the main clinical manifestations,can be associated with different levels of proteinuria. Clinical manifestations have big differences, light person only with microscopic haematuria, serious with radical nephritis. Its clinical is a chronic progress, IgA nephropathy has become one of the leading cause of end-stage renal disease. After40years of long-term clinical observation and pathological research, the complexity of the pathogenesis of IgA nephropathy, now is still not entirely clear.Because of its clinical manifestations and pathological diversity and parallelism, there is no unified clinical classification and pathological classification method, and no unified and effects of treatment. Coping with IgA nephropathy has become the consensus of pediatric kidney disease doctors, and early diagnosis and treatment according to different clinical manifestation and pathological changes, may improve the prognosis of children with IgAN.Objective:This study aims to analyze children primary clinical manifestation and pathological characteristics of IgA nephropathy, learn the relationship between the clinical manifestations and pathological changes, to guide clinical treatment.Methods:Of the Shandong Provincial hospital from2006to2013and the renal biopsy diagnosed,the clinical data of110cases of primary IgA nephropathy patients were analyzed retrospectively, to observe the characteristic of different clinical manifestations and pathological type, understand its clinical manifestation and pathology classification.Results:(1)From January12006to December312013,110hospitalized children were diagnosed as IgAN by kidney—puncture. Comflete records were available for110patients, The male to female ratio was1.68:1. The ages at the disease diagnosis were(8.64±2.29)years.(2)50%of patients had predisposing causes, especially infection:respiratory infection is most common predisposing causes, followed by gastrointestinal infection.(3)The most common "chief complaint" of the patient is macroscopic hematuria(with or without proteinuria), its proportion is59.1%. the type of hematuria and proteinuria (49.1%)was the most common clinical manifestation, followed by the type of Nephritic syndrome (36.4%).(4)Subclass111(53.6%)were the most common histologie types. The main type of immune—complex deposition was IgA.(5)There is significant distinction of pathological lesion distribution in different clinical type. There is also significant distinction of pathological lesion distribution in different immune complex deposition.there is a positive correlation between IgA and C3deposition.(6) The pathological lesion of IgA nephropathy logistic regression analysis of risk factors says proteinuria is the independent risk facter.Conclusion:(1)The patients of boys are far more than girls.(2) the type of hematuria and proteinuria is the most common clinical manifestation (3)Subclass III is the most common histologic type. The main type of immune—complex deposition is IgA.(4)There is significant distinction of pathological lesion distribution in different clinical type. There is also significant distinction of pathological lesion distribution in different immune complex deposition.there is a positive correlation between IgA and C3deposition.(5) The pathological lesion of IgA nephropathy logistic regression analysis of risk factors says proteinuria is the independent risk facter.