Factors Contributing to the Outcome in Adult Patients with Idiopathic Membranous Glomerulonephritis: Single Center Study in Korea / 대한신장학회잡지

ABSTRACT

The 70 adult patients with idiopathic membranous glomerulonephritis(IMGN), in whom renal biopsy has been performed at Keimyung University Dongsan Hospital, between January 1982 and December 1995 were studied for the clinical evolution of the disease and factors which might be involved in the development of chronic renal failure. There was 41 males and 29 females with a mean age of 41 years. Mean time from the onset to the renal biopsy was 13 months. The clinical presentations at the time of diagnosis were nephrotic syndrome(61.4%), asymptomatic urinary abnormality(21.4%), acute nephritic syndrome(14.3%), and recurrent gross hematuria(2.9%). During the mean follow-up period of 40+/-31 months, eleven(15.7%) of the patients developed chronic renal failure and five of them had end-stage renal disease. Five and ten years renal survival were 81.2% and 66.4%, respectively. In univariate analysis of clinical prognostic factors for progression to renal failure using Kaplan-Meier method, four parameters ; serum creatinine >or=1.4mg/ dL(p=0.011), hypoalbuminemia 2.5g/dL(por=10.0g/day(p=0.036) and remission of proteinuria < 2.0g/24hr (p<0.01) were found to have predictive value. No effect was observed in the age, sex, steroid and/or immunosuppressive therapy, hypertension and serum total cholesterol concentration on prognosis. In univariate analysis of pathologic prognostic factors, interstitial fibrosis(p=0.036) and inflammation(p=0.011) were significant for predictive value.