| Objective:This study aims to analyze the clinicopathologic data of histologically confirmed IMN in 396 patients and to summarize the general incidence,clinicopathologic characteristics and clinicopathologic correlation of IMN patients and discuss the disease general incidence and its characteristics.Methods:A number of 396 patients with IMN in the Second Hospital of Jilin University during Jan 2005 to Dec 2015 were retrospectively analyzed. The clinicopathologic data were analyzed according to gender, age, pathologic stage, the level of proteinuria and e GFR.Results:1)396 IMN patients were involved. There were 268 males and 128 females and the ratio of male to female was 2.09:1. The age of the IMN patients ranged from 14-85 and the average age was 50.61±13.58. The patients were mainly elders. There were 161 urban patients and 235 rural patients. The prevalence ratio of urban and rural patients was 0.69:1. The IMN patients accounted for the proportion of patients with renal biopsy showed an increasing trend by years. The pre-biopsy course ranged from 0.1-360 months and the average pre-biopsy course was 12.14±37.08. The levels of proteinuria were ranging from 0.17-20.54g/24 h. 71.2% patients were with proteinuria>3.5g/24 h. The serum albumin ranged from 10.2-49.6g/L and there were276(69.7%) patients whose serum albumin level were below 30g/L. All the 396 cases had different levels of proteinuria in which 307(77.5%) were clinically diagnosed with nephrotic syndrome 270( 68.2%) patients had hematuria, 199(50.3%) IMN patients had hypertension, and there were 37(9.3%)patients were with e GFR≤60ml·min-1·1.73m-2.2)Compared with female patients, the males had more serious clinical features and injury of renal function. The incidence of nephrotic syndrome, hematuria,hypertension and anemia in elderly patients were higher than that in the young group.And the injury of renal function was more serious than that in the young patients.With the increasement of proteinuria, the level of serum albumin gradually decreased and the levels of blood lipid gradually increased(P<0.05), clinical manifestations were more serious and the level of e GFR gradually decreased(P>0.05). With the decline of renal function, clinical features and tubulointerstitial lesions were more serious. The percentage of pathologic stage I, II, III and IV of IMN were accounted for 37.1%, 57.6%, 4.3% and 1.0%, Stage II was the most common pattern and patients of stage I and II of IMN were accounted for 94.7%. This study showed that there was no significant statistic in different pathological stages among gender, age,the incidence of hypertension, tubulointerstitial lesions and laboratory indexes. In396 cases, 23 cases of IMN accompanied with renal arteriolar sclerosis, 6 cases combined with diabetic nephropathy, 5 cases combined with Ig A nephropathy, 1cases accompanied with obesity related nephropathy and 324 cases accompanied with different levels of tubulointerstitial lesions.Conclusion:1) In general, through this research, the IMN patients accounted for the proportion of patients with renal biopsy showed an increasing trend during the past ten years.2)NS is the most common clinical manifestations of IMN. Hematuria occurs in most patients. Partial patients are accompanied with hypertension and renal insufficiency.3)In IMN, stage II is the most common pattern and stage I is the second most common one. The pathological results and clinical symptoms were not completely corresponding.4)Male, old age, serious clinical manifestations, higher pathologic stage and tubulointerstitial lesions are the risk factors affecting renal function of IMN patients. |
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