Clinical And Pathological Characteristics Of IgA Nephropathy With Thin Glomerular Basement Membrane

Objective:To analyse the proportion of IgA nephropathy patients with uniformly thin glomerular basement membrane (TGBM-IgAN), as well as the comparison of the differences in the clinical and pathological features between TGBM-IgAN and the normal glomerular basement membrane group (NGBM-IgAN)Methods:Pathological characteristics of120patients with IgA nephropathy confirmed by renal biopsy, we measured the thickness of glomerular basement membrane (GBM) by transmission electron microscope.We put the patients in group TGBM-IgAN whose GBM thickness under250nm, and the others in group NGBM-IgAN.Then we compared the clinical and pathological characteristics as well as prognosis of the two groups.Results:The GBM thickness of TGBM-IgAN is (210.89±17.47) nm, while the normal GBM is (324.57±34.60) nm.TGBM-patients accounted for23.3%of the IgA nephropathy patients. The male-to-female incidence ratio was about0.27:1, and the family hitory incidence is higher than group of NGBM-IgAN.The hematuria incidence, the rate of proteinuria and the hypertension rate, and the renal disfunctional rate is higher than group of NGBM-IgAN, while there is no difference between the two groups in the incidences of hypoalbuminemia and hyperuricemia as well as the concentration of serum IgA. The focal and (or) segmental glomerulosclerosis takes the most part of the two groups, while the minor lesion rate is higher in TGBM-IgAN, and sclerosis of hyperplasia or sclerosis, global or segmental sclerosis and crescent formation incidences were higher in NGBM-IgAN. The proportion of glomerular global sclerosis was mainly concentrated in less than10%in TGBM-IgAN, while the proportion was more than10%in NGBM-IgAN.In the Oxford classification, the most TGBM-patients were M1S0E0T0, and the most NGBM-patients were M1S0E0T0and M1S1E0T0.The pathological changes in NGBM-patients were more severe than that of in TGBM-patients.There was no difference between the two groups in immunopathogenesis.Conclusions:The clinical and pathological changes were more mild in TGBM-patients than NGBM-patients. On the one hand, We should pay attention to the examination of electronic microscope and trace the TGBM-patients to observe the relationship between the familial TBMN.On the other hand, we shoud follow up NGBM-patients and delay the progression of their kidney injury with active treatment.