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Objective To detect the expression levels of renal tissue M-type phospholipase A2 receptor 1(PLA2R1) antigen and its antibody in the patients with membranous nephropathy(MN).Methods Fifty-eight cases of biopsy-proved idiopathic membranous nephropathy(IMN),fifteen cases of hepatitis B-associated membranous nephropathy(HBV-MN) and seventeen cases of V type lupus nephritis(V-LN) were selected.Renal tissue PLA2R1 antigen was detected by indirect immunofluorescence and colocaliazed with IgG4.Serum anti-PLA2R1 antibody was simultaneously examined.The expression difference of PLA2R1 antigen and antiPLA2R1 antibody in MN was analyzed.And the differences of clinical data were analyzed between PLA2R1 positive and negative patients.Results The PLA2R1 antibody was not found in the renal tissue and serum of the patients with LN and HBV-MN;PLA2R1 antigen was found in 81.03％ of IMN patients,and its antibody was found in serum of 70.69％ of IMN patients.PLA2R1 antigen and IgG4 co-localization all deposited along glomerular capillary loop presenting as fine granules.The 24 h urine protein level in the patients with PLA2R1 antigen deposition in renal tissues was higher than that in the patients without PLA2R1 deposition (P＜0.05),moreover serum albumin level was lower than that in the patients without PLA2R1 deposition(P＜0.05).Conclusion The sensitivity and specificity of renal tissue PLA2R1 antigen in the diagnosis of IMN are higher.The expression of PLA2R1 antigen in renal tissue by biopsy is significantly correlated with the clinical severity.
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OBJECTIVE: To report the current situation of dialysis and transplantation in Foshan City. METHODS: A total of 18 hospitals performed dialysis filled the registration forms, which comprised situations of hospital, staff establishment, blood purification developing, blood purification equipments, hemodialysis patients, peritoneal dialysis patients, and acute renal failure patients. The registration time was form the beginning to ending of 2007, and the information was statistical analyzed.RESULTS: Totally 18 hospitals in Foshan district performed hemodialysis and 6 of them offered peritoneal dialysis simultaneously. There were 155 hemodialysis machines, 6 CRRT machines, and 15 dialyser reuse devices. Totally 1 718 patients received dialysis in 2007 year, including 93.60% hemodialysis patients and 6.40% peritoneal dialysis patients. Until the end of 2007, 1011 patients were received dialysis treatment, including 90.60% hemodialysis and 9.40% peritoneal dialysis. Glomerulonephritis (47.1%) was still the first primary disease of dialysis, then diabetic nephropathy (28%), third arteriosclerosis nephropathy (9.7%), fourth obstructive nephropathy (3.2%). Totally 743 hemodialysis patients stopped treating for reasons of death, improvement or recovery, changed to peritoneal dialysis, kidney transplantation, transfer, economics and lost follow-up, accounted for 20.3%, 20.1%, 7.2%, 4.1%, 21.5%, 20.2% and 6.6%, respectively. Cerebrovascular disease, cardiovascular disease, infection, dystrophy, synthetic factors and other were the main reasons for death, which accounted for 16.6%, 28%, 17.2%, 3.2%, 18.4% and 16.6%. A total of 16 patients stopped peritoneal dialysis for death (68.7%), improvement or recovery (18.7%), changed to hemodialysis (7.1%), or lost follow-up (6.3%). The causes of death were cerebrovascular disease (21.4%), cardiovascular disease (7.1%), infection (28.6%) and others (42.9%).CONCLUSION: There are 18 hospitals can perform dialysis treatment in Foshan district. Glomerulonephritis, diabetic nephropathy, arteriosclerosis nephropathy and obstructive nephropathy are the first four primary diseases of dialysis. Cerebrovascular disease and infection are the main causes of death.