Clinical And Pathological Analysis In 1376 Cases Of Idiopathic Membranous Nephropathy

Objective:To analyze the clinical and pathological features of idiopathic membranous nephropathy(IMN)in a single center.Methods:A total of 1376 cases of IMN patients received renal biopsy from January 2015 to December 2017 were enrolled.According to age they were divided into three groups:young group(age<44 years old),middle-aged group(age 45-60 years old)and elder group(age?60 years old),to analyze the distribution of different ages and gender and the relationship between clinical features and pathological characteristics.Results:1.1367 cases of IMN accounted for 23.6%of the total number of renal biopsies(5819 cases)at the same period in our department and the proportion of IMN was higher than 10.8%in 1999-2006 and 16.8%in2008-2011.IMN was frequent in patients between 45-60 years old.The ratio of male to female was about 1.5:1.2.Nephrotic syndrome(NS)occurred in 765 patients(55.6%),without any significant differences in ages(P>0.05).NS was more common in male,the differences were significant(P<0.05).1143 patients(83.0%)presented edema,more common in the elder group and female patients(P<0.05).449patients(32.6%)with hypertension,which was more prone to the elder group(P<0.05).The gender differences in hypertension were not significant(P>0.05).31 patients(2.3%)with renal dysfunction,which was higher in the elder group and male patients(P<0.05).Male had more proteinuria than female.There were no significant differences in proteinuria between ages(P>0.05).3.91.9%cases were classified as stage I membranous lesions in pathology,which was more common in the elder group(P<0.05),without any significant differences in gender(P>0.05).There were no significant differences in proteinuria and eGFR between pathological stages(P>0.05).The incidence of glomerulosclerosis was higher in patients whose eGFR<60ml/(min×1.73m~2)(P<0.05).The eGFR was lower in patients with focal segmetal glomerulosclerosis(FSGS)than those without FSGS(P<0.05).Conclusions:The proportion of IMN in was increased in our department,with a high incidence of 45-60 years old.Male was predominant in all of the cases.The pathological stage of IMN was dominated by stage I.The main clinical manifestation was nephrotic syndrome.The elder patients were more common with edema,hypertension and renal dysfunction.Male had more proteinuria and lower eGFR than female.Proteinuria and eGFR could not predict the pathological stage,but eGFR could predict the degree of chronic renal pathology.