| Objective: To explore the difference of clinicopathological features and prognosis between young and elderly patients with idiopathic membranous nephropathy.Methods: Patients with idiopathic membranous nephropathy diagnosed by renal biopsy admitted to Nephrology Department of Shengjing hospital affiliated to China Medical University from September 2011 to September 2017 were selected.Only patients with nephrotic syndrome and accepting glucocorticoid and/or immunosuppressant and followed up at least 6 months were enrolled in this study.Patients were divided into two groups according to age,one was youth group(≤35 years old),and the other was aged group(≥60 years old).Their clinical and pathological features and therapeutic effect were compared.Results: A total of 81 patients were enrolled in the study and 40 cases were in youth group and 41 cases were in aged group.Compared to patients in aged group,the patients in youth group had lower proportion of renal insufficiency and hypertension.The levels of hemoglobin,serum albumin and estimated glomerular filtration rate(eGFR)were higher as compared with patients in aged group.Moreover,the proportion of hematuria and the level of cholesterol,triglyceride,and LDL-C of patients were lower in youth group than in aged group(P<0.05).The renal pathological changes including tubular atrophy,renal interstitial fibrosis and small vascular lesion were more mild in youth group than in aged group(P < 0.05).Further regression analysis showed that eGFR,proportion of hematuria,and tubular atrophy still had statistical significance in youth group and aged group.There was significant difference in total remission rate :patients in youth group had higher total remission rate as compared with patients in aged group after treatment and have a more rapid onset of action.Conclusion: Young patients are less accompanied by comorbidity,renal insufficiency and more slight renal pathological changes.The prognosis is better in youth group. |
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