Clinical features and treatment strategies of idiopathic membranous nephropathy
WANG Qian1, GAO Yan2, LI Linqian1, LI Xiangmeng1, CHEN Yujie1, ZHANG Haisong2, and XING Liang3
1.Medical School of Hebei University,Baoding 071000,China; 2.Department of Renal Medicine, 3. Department of Pathology, the Affiliated Hospital of Hebei University, Baoding 071000, China
Abstract：Objective To explore the clinical features and treatment of idiopathic membranous nephropathy (IMN).Methods The clinical and renal pathological data of 336 patients with IMN treated at the Affiliated Hospital of Hebei University between July 2015 and June 2017 was analyzed retrospectively.Results (1)Among the 336 cases of IMN patients, the ratio of urban patients to rural ones was 0.29∶1.283 of these patients were farmers, whose percentage was significantly higher than that of other occupations.This disease was more prevalent in spring than in other seasons.(2)IMN patients were characterized by nephrotic syndrome and chronic nephritis syndrome, with high blood pressure and microscopic hematuria.(3)Most of the patients were in stage 1 according to pathological staging, accounting for 58.6%. 63.1% of the patients had renal tubule-interstitial damage.Immunofluorescence showed that the immune complex was mainly formed by IgG and C3.(4)Compared with the young and middle-aged groups, high blood pressure was more prevalent in the elder group. The proportion of hematuria in the middle-aged group was higher than in other groups.There was no statistically significant difference in diastolic blood pressure, anemia, albumin, serum creatinine, total cholesterol, triglyceride and glomerulosclerosis integrals between the three groups.(5)With the increase of pathological staging,the proportion of patients with anemia increased gradually, so did the glomerulosclerosis integral.There was no statistically significant difference between the pathological stages in the percentage of males, the proportion of hypertension, blood urine, 24-hour urine protein, blood albumin, serum creatinine and eGFR.Conclusions The clinical treatment of elders, male patients, mass proteinuria, those with high pathological staging, renal tubule and interstitial fibrosis is more important.
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2018, Vol. 29 
