Clinical and pathological features of idiopathic membranous nephropathy: a report of 118 cases

Objective To summarize the clinic-pathological features of idiopathic membranous nephropathy(IMN). Methods The clinical and pathological data of 118 cases of IMN confirmed by biopsy in Zhejiang Provincial People's Hospital from January, 2013 to October, 2016 were analyzed retrospectively. Results Of the 118 IMN patients, there were 69 males and 49 females, with mean age of 51.7±12.3(74.6% of them were 44 years or more). The level of protein in urine was 0.07-27.60 g/24 h, and 3.5 g/24 h or more in 58.5% of them. 76 cases(64.4%) were with nephrotic syndrome, 102 cases(86.4%) with hematuria. 102 cases(86.4%) were with eGFR of 60 ml/(min·1.73 m²) or more, and 16 cases with eGFR less than 60 ml/(min·1.73 m²). When compared with female patients, the male patients were with higher levels of serum creatinine level, blood urine nitrogen and uric acid level, the difference was statistically significant(P<0.05). Age and urine protein quantification had positive correlation with the level of serum creatinine, urate, eGFR, tubulointerstitial lesions, glomerulus sclerosis and small artery injury. Pathological stage Ⅰ and Ⅱ of IMN were the dominant pathologic pattern, which accounted for 97.5%cases. Conclusion The aged male IMN patients are usually with high uric acid and urine protein levels, renal hypofunction, tubulointerstitial lesions and small artery injury, and the early renal biopsy and diagnosis should be recommended to IMN patients.