Prognosis And Clinicopathological Features Of Idiopathic Membranus Nephropathy

Objective:Discuss clinical and pathological features with idiopathic membranous nephropathy patients and analysis prognostic factors of renal insufficiency.Methods: The study included from January 2010 to March 2015 in the Xinjiang Autonomous Region People’s Hospital and diagnosed by biopsy.Based on the eGFR and urinary protein baseline levels were grouped.Follow-up of patients according to whether reach the end of preset;Draw ROC curve to determine the index threshold,percentage of endpoint assessed by Kaplan-Meier curves, using Cox proportional hazards regression models to explore the prognostic factors.Results:(1)241 cases were enrolled, male 171 cases(70.9%), female70 cases(29.1%), male and female ratio about 2.4:1,all patients had varying degrees of proteinuria, which 25 patients(10.4%) proteinuria>10g/d,27 patients(45%) patients with has remission during follow-up;(2)In serum albumin, urinary β2-MG, FSGS and renal tubular interstitial damage has statistically significant,but showed no significant difference on hematuria and renal small vessel disease between different stages of eGFR.(3)Indicators of eGFR and smoking has statistically significant between groups of 24 hours urine protein.(4)In multivariate analysis, age, proteinuria, urinary IgG, urinary β2-MG and tubular interstitial damage statistically has significant effect on renal function,95% CI,respectively(1.056,1.158)、(1.904,2.245)、(1.008,1.075)、(0.491,1.979)(0.163,1.146).( 5) Prognostic factors analysis show that urine β2-MG, urinary IgG was statistically significant, P were 0.046 and 0.003,95% CI were 1.105 ~ 1.137 and 1.015 ~1.076.Conclusion:( 1) iMN more common in men, it can occur remission in some patients;(2)All patients had varying degrees of proteinuria, male, smoking, low serum albumin concentration, high pathological stage, longer duration of iMN patients has numerous excretion of protein and severe renal function;(2)Urinary β2-MG, urinary IgG on prognosis of the disease have a certain value, and is an independent risk factor for the decline in renal function.