Clinical and Pathology Features of Idiopathic Membranous Nephropathy with Tubulo-interstitial Damage / 医学研究杂志

ABSTRACT

Objective To investigate the clinical manifestation and pathological features of idiopathic membranous nephropathy with renal tubule-interstitial damage(TID).Methods Totally 329 patients who were treated and diagnosed as idiopathic membranous nephropathy(IMN) by renal biopsy in Guangdong Provincial Hospital of Traditional Chinese Medicine from September 2010 to December 2016 were included in the retrospective research.According to the degree of tubule-interstitial damage,they were divided into 4 groups,grade 0(52 patients),grade Ⅰ (246 patients),grade Ⅱ (22 patients) and grade Ⅲ (9 patients).The clinical and pathological characteristics were analyzed.Multivariate logistic regression analysis was used to analyze the influence factors.Results The incidence rate of TID in 329 IMN patients was 84.2％.Compared with grade 0,grade Ⅱ and Ⅲ had more male patient,an older average age,longer course of disease and more higher proportion of history of hypertension.There were significant differences in Alb,eGFR,Scr,BUN and 24h urinary protein between grade 0,Ⅰ to grade Ⅱ,Ⅲ (P ＜ 0.05,respectively).The group with TID which pathologic stage was mainly in stage Ⅱ,showed an higher renal small vessel disease.Multivariate logistic regression analysis showed that age,hypertension,course of disease,Scr and renal small vessel disease were independent risk factors of IMN-TID.Conclusion IMN patients with TID had more severe clinical manifestations.The pathological features were significant in renal small vessel disease.There was no significant difference in pathological grade.The age and hypertension history,course of disease and renal small vessel disease were independent risk factors of IMN-TID.Scr levels can indirectly reflect the degree of TID.