The Significance Of Renal IgM Deposition In Adult Idiopathic Membranous Nephropathy

Objective To explore the relationship between renal Ig M deposition,clinical and pathologic changes in idiopathic membranous nephropathy(IMN)patients.Methods A retrospective analysis of the data was made in the First Affiliated Hospital of Anhui Medical University from December 2015 to June 2017.The data of 95 cases were diagnosed by nephrology renal biopsy as adult idiopathic membranous nephropathy patients.It detected position and degree of the Ig M in glomeruli by direct immunofluorescence,then divided into Ig M deposition group and Ig M negative group.The serum Anti-phospholipase A2 receptor antibody was detected by indirect immunofluorescence,and the pathologic staging was made by Ehrenreich-Churg staging criteria.To compare and analyze the clinical,pathological and laboratory indexes of the two groups.To analyze the sex,age,serum uric acid,total cholesterol,24 h urinary protein,urinary FDP,urinary cystatin C,blood immune globulin(Ig G,Ig A,total Ig E,Ig M),serum albumin,serum creatinine,blood urea nitrogen,triglyceride,high density lipoprotein cholesterol,non-high density lipoprotein cholesterol,very low density lipoprotein cholesterol,low density lipoprotein cholesterol,apolipoprotein A,apolipoprotein B,Lipoprotein(a),the urinary protein includes totalprotein,transferring,retinol binding protein,N-acetyl-?-D-glucosaminidase,albumin,Ig G,?2-microglobulin,?1-microglobulin and serum anti-phospholipase A2 receptor antibody of the two groups.Results The levels of serum uric acid in the same sex group,total cholesterol,24 h urinary protein,urinary FDP and urinary cystatin C in Ig M deposition group were significantly higher than those in Ig M negative group(P<0.05),the pathological damage of Ig M deposition group was more obvious than Ig M negative group(P<0.05);blood immune globulin(Ig G?Ig A?total Ig E?Ig M),serum albumin,serum creatinine,blood urea nitrogen,triglyceride,high density lipoprotein cholesterol,non-high density lipoprotein cholesterol,very low density lipoprotein cholesterol,low density lipoprotein cholesterol,apolipoprotein A,apolipoprotein B,Lipoprotein(a),the urinary protein includes total protein,transferring,retinol binding protein.N-acetyl-?-D-glucosaminidase,albumin,Ig G,?2-microglobulin,?1-microglobulin and serum anti-phospholipase A2 receptor antibody compared between patients with the two groups,the difference was not statistically significant(P>0.05).Conclusions Ig M deposition of idiopathic membranous nephropathy in patients have more severe urinary protein,more obvious pathological damage and more risk of renal tubule injury,suggesting that the disease is more serious.