The Clinical And Pathological Features And Follow-up Analysis Of Idiopathic Nephrotic Syndrome Complicated With Clonorchiasis Sinensis

Objectives: To research the Clinical and pathological characteristics,disease development and prognosis of patients with idiopathic nephrotic syndrome(INS)complicated with clonorchis sinensis infection.Methods: There is a retrospective analysis about the clinical and pathological data of 154 patients diagnosed with idiopathic nephrotic syndrome with renal biopsy in the renal Department of the first affiliated hospital of Guangxi medical university from June 2012 to June 2018 and followed up.78 patients with idiopathic nephrotic syndrome complicated with clonorchiasis sinensis were selected as the observation group,and 76 patients without clonorchiasis were randomly matched according to pathological type,gender and age as the control group.Baseline data and differences in renal pathology were compared between the two groups.All-cause death,end-stage renal disease(ESRD)and the first remission were the endpoint events,and Kaplan-Meier method was used for survival analysis.Results: The serum creatinine and eosinophil counts(EOS)of the patients with idiopathic nephrotic syndrome complicated with clonorchis sinensis were higher than those of the control group,and the estimated glomerular filtration rate(eGFR)and hemoglobin were lower than those of the control group,and renal pathology in mesangial proliferation,renal tubular atrophy,granular degeneration,loss of brush border,tube type of protein,inflammatory cells infiltration than control group obviously,give priority to with lymphocyte infiltration,IgA,IgM deposits more than control group,differences were statistically significant(P<0.05).The remission rate of nephrotic syndrome in the control group was higher than that of clonorchiasis sinensis combined group,while the All-cause mortality and Renal survival in the latter group was higher than that in the control group.The remission rate of clonorchiasis was lower when treated with hormone monotherapy or hormone + immunosuppressant therapy.In patients with clonorchiasis sinensis,the remission rate of hormone + immunosuppressant combined therapy was higher than that of hormone or immunosuppressant single therapy,and the remission rate of insect repellent therapy was higher than that of those without insect repellent therapy,but the difference was not statistically significant.Conclusions: Patients with idiopathic nephrotic syndrome complicated with clonorchis sinensis infection had more obvious renal function damage,decreased hemoglobin,pathological mesangial hyperplasia,renal tubular damage and infiltration of renal inflammatory cells,with lower clinical remission rate and higher All-cause mortality and Renal survival rate.The remission rate of nephrotic syndrome in the control group was lower than that of the control group when treated with hormone monotherapy or hormone + immunosuppressant therapy.