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A Retrospective Analysis of the Clinical and Pathological Features in Primary IgA Nephropathy in 150 Cases in Shenzhen

Author: SongHaiYing
Tutor: HeYongCheng；ZuoShaoDong；WanQiJun
School: Guangzhou Medical College
Course: Medical kidney disease learn
Keywords: IgA Nephropathy Clinical Renal pathology Retrospective study
CLC: R692.3
Type: Master's thesis
Year: 2010
Downloads: 7
Quote: 0
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Abstract


ObjectiveTo study the clinical and pathologic Features of 150 cases of primary IgA nephropathy (IgAN) in ShenZhen and in order to provide helpful information for diagnosis and treatment of the disease.MethodsThe clinical and pathological data of 150 cases of primary IgAN , diagnosed by renal biopsy from January 2006 to December 2007 in Shenzheng 2nd people’s hospital, were retrospectvely analyzed.ResultsThere were 69 male and 81 female patients in the analysis group and the ratio of male to female was 1:1.17. The main part of patients were aged from 30 to 39 which occupied 49.3% of the analysis group. 2. Hematuria was found in 114 (76%) cases of the analysis group which included 44 males and 70 females, 46 cases with pure hematuria and 68 cases with hema-proteinuria. Macroscopic hematuria was found in 44 (29.3%) cases, in which 24 cases were acute tonsillitis related. Proteinuria was found in 104 (69.3%) cases, which included 36 cases of pure proteinuria and 68 cases of hema-proteinuria. There were 37 (24.7%) cases with mild proteinuria,51 (34.0%) cases with moderate proteinuria and 16 (10.6%) cases with severe proteinuria. 3. Analysis of pathological data revealed that cases with Lee’s classificationⅣ-level accounted for 33.3% of the analysis group respectively and was higher than other grades. Deposition of IgA in mesangial area was found in 104 (69.3%) cases, and deposition of IgA both in mesangial area and vascular loops were found in 46 (30.7%) cases under fluorescence microscope (P﹤0.01). 4. Analysis of patholohical and clinical data revealed that the Lee’s grade has a positive corelation with the incidence of proteinuria (r=0.588,P<0.05). There was no significant difference among different Lee’s grades in hematuria cases (P>0.05). Hypertension showed a positive corelation with the Lee’s grade (r=0.557, P<0.000).Impaired renal function had a positive corelation with the Lee’s grade (r=0.678, P<0.000). 5.The single-factor analysis of regression equation showed that Lee’s grade (P=0.000) and hypertention (P=0.001) were effctive influence factors of impaired renal function. The multi-factor analysis of logistic regression equation revealed that Lee’s grade (P=0.000) and hypertension (P=0.001) were independent risk factors of impaired renal function.Conclusion1. In this group of primary IgAN cases, patients aged from 30 to 39 were the most popular group and females slightly outnumber males.2. In this group of primary IgAN cases, occurrence of hematuria was significantly higher in females than in males. The most frequent incentive factor of macroscopic hematuria was acute tonsillitis.3. In this group of primary IgAN cases, deposition of IgA in mesangial area was main charactor, and deposition of IgA both in mesangial area and vascular loops also frequently appeared.4. In this group of primary IgAN cases, the quantitation of urine protein output has positive corelation with Lee’s grade and incidence of proteinuria increased along with higher Lee’s grade.5. In this group of primary IgAN cases, hypertension had a positive corelation with the Lee’s grade and Lee’s grade was higher in patients with hypertension.6. In this group of primary IgAN cases, the incidence of abnormal renal function was positively corelated with Lee’s grade and Lee’s grade was higher in patients with impaired renal function.7. In this group of primary IgAN cases, Lee’s grade and hypertension were independent risk factors for patients with impaired renal function.

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