Clinical And Pathological Characteristics And Risk Factors Associated With Renal Lesions Of 91 Patients With Mild Asymptomatic Proteinuria Or/and Hematuria

Objective:To study the clinical and pathological characteristics of 91 patients with mild asymptomatic proteinuria or /and hematuria and the risk factors of the renal pathologic changes.Methods: 91 patients with mild asymptomatic proteinuria or /and hematuria were collected from January 2002 to May 2011 at the First Affiliated Hospital of Dalian Medical University, Department of Nephrology. The patient at age of 18-80 years old, with primary glomerulopathy, no clinical manifestations of hypertension and edema and normal renal function were enrolled. Non-glomerular hematuria or proteinuria and secondary glomerulopathy such as diabetic nephropathy, systemic lupus erythematosus, multiple myeloma, anaphylactoid purpura, hepatitis and vasculitis were excluded. Renal biopsy was operated on all patients, and urine routine test and urinary protein excretion were also messured. According to the severity of renal pathologic changes[1],all patients were divided into two groups (mild renal lesion group and severe renal lesion group), then the relationship between renal pathologic changes and clinical factors was evaluated. All statistical calculations were performed by SPSS software (version 17.0). All data were presented as mean±standard deviation. Independent-Samples t-test was applied for comparison of the between-group variations, andχ2 test for comparison of frequencies. The risk factors affected renal pathology damagement degree were analyzed by multiple regression analysis. p value less than 0.05 was considered significant.Results: In all patients, 53.8% (49 cases) were suffered from hematuria and proteinuria simultaneously, 44.1% (40 cases) hematuria alone, 2.1% (2 cases) proteinuria alone. 71.4% (65 cases) presented IgA nephropathy, and 28.6% (26 cases) were lesions-severe pathological damage with hematuria and proteinuria, whose urinary protein excretion was significantly higher than the mild disease group (χ2= 4.253, p=0.039). Logistic regression analysis showed that proteinuria was the independent risk factor of pathological changes (OR=1.004, CI: 1.001~1.007, p= 0.006), in other words, severe degree of pathological changes increased with increasing proteinuria. In addition, the course of disease was another independent risk factor of pathological changes (OR = 1.276, CI: 1.078 ~ 1.510, p = 0.006).Conclusion: Pathological changes of asymptomatic or/and mild proteinuria were various, in which IgA nephropathy was more common. The proportion of severe pathological changes increased in patients with hematuria and proteinuria. Proteinuria were independent risk factors. Even though mild proteinuria (urine protein excretion≤1g/24h) was significantly related to pathological damage. Therefore, renal biopsy and in time were necessary for the patients mild asymptomatic proteinuria or /and hematuria.