Clinicopathological analysis of idiopathic membranous nephropathy in young adult Chinese patients

WANG Yan-yan; DONG Hong-rui; SUN Li-jun; ZHANG He-jia; ZHANG Jian-rong; ZHAO Xiao-yi; SUN Zhan-shan; CHENG Hong; CHEN Yi-pu

doi:10.19538/j.nk2017060116

Abstract：Objective To investigate the clinicopathological features of idiopathic membranous nephropathy (IMN) in young adult Chinese patients.Methods The clinicopathological manifestations and therapeutic effects were retrospectively analyzed in the patients with IMN diagnosed by renal biopsy from Jan.2012 to Sep.2016,and compared between group A (≤ 35 years) and group B (＞35years).Results There were 537 patients with IMN in this study,accounting for 25.8％ of the cases of renal biopsy and 32.5％ of the cases of primary glomerular disease.Among them,there were 20.9％ patients in group A.The disease course of group A was shorter than that of group B (P＜0.05).The proportions of nephrotic syndrome and renal insufficiency in group A were lower than those in group B,while the proportion of asymptomatic proteinuria in group A was higher than that in group B (P＜0.05).The patients with obesity,diabetes or/and hypertension in group B were significantly more than those in group A (P＜0.05 or P＜0.01).95.0％ and 91.8％ patients had the deposition of predominant IgG4 subclass and PLA2R on glomerular capillary wall,respectively.Among the patients without glomerular PLA2R deposition,11.4％ had THSD7A deposition on glomerular capillary wall.However,the differences of the positive rates of predominant IgG4,PLA2R and THSD7A deposition in glomeruli between A and B groups were not significant (P＞0.05).There was no statistical difference in treatment effects between the two groups (P＞0.05).Conclusion The deposition of pathogenic antibodies and antigens in glomeruli and the treatment effects were similar between the IMN patients in group A and group B,which suggests there are no substantial differences between the patients of these two groups.Some differences in clinical manifestations and treatment regimens between these two groups may caused by age factor and complications.