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Clinicopathologic Features and Prednisone Therapeutic Effect of IgA Nephropahty with Minimal Change Like Lesion

Author: ZhangXiRan
Tutor: WangQingWen；LiuZhiHong
School: Nanjing University
Course: Internal Medicine
Keywords: IgA nephropathy mnimal change like lesion clinicopathologic features prednisone therapeutic effect
CLC: R692.3
Type: Master's thesis
Year: 2011
Downloads: 42
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Abstract


Objective:To investigate the clinicopathologic features and prednisone therapeutic effect of IgA nephropathy with minimal change like lesion.Methodology::61 patients[46 male and 15 female with average age of (23.92±8.65) years old] who were biopsy-based IgA nephropathy with the minimal change like lesion were enrolled in this retrospective study. Their clinical menifestation,pathological feature and prednisone therapeutic effect were analyzed.Results:All patients onseted with swollen, and 15 cases (24.6%) obviously took infection as a motivation.Nephrotic syndrome was the primary clinical menifestation.14 cases (23.0%) showed AKI,5 cases (8.2%) presented with hypertention and 14 cases (23.0%) showed hematuria. The ascending of urine n-acetyglucosaminidase (NAG) (78.7%) and urine retinol binding protein (RBP) (75.4%) were seen in a majority.Changes were minimal with the glomerulus,The renal tubules and interstitial tissues obviously got acute injury with a proportion of 80.3% and 65.6% respectively.During the follow-up of 46 months(24～70 months),the effective and relapse rate of prednisone therapy were 91.8% and 76.8%.Compared to responders,the nonresponders got a higher incidence and severity of hematuria (P<0.01) and the hypoproteinemia was not as obvious as the former (P<0.05).Besides,tubular atrophy, interstitial fibrosis and hyaline degenetantion of arteriole appeared more often in nonresponders (P<0.01).Till the last follow-up,59 cases (96.7%) still had nomal renal funtion.Conclusion:IgA nephropathy with minimal change like lesion were similar with minimal change desease both in clinical menifestation and pathological feature.Most cases got remission with prednisone therapy,and they usually showed good prognosis.

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CLC: > Medicine, health > Surgery > Urology ( urinary and reproductive system diseases) > Kidney disease > Nephritis
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